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What is Hemorrhagic stroke?

Hemorrhagic stroke (Brain Hemorrhage) is spontaneous bleeding into the brain caused by a rupture of an artery due to hypertension (commonest cause) or abnormalities in the arteries and veins like aneurysms or atriovenous malformations. Increasingly blood thinners are also responsible for hemorrhagic strokes

How common is hemorrhagic strokes?

Hemorrhagic strokes account for up to 15% of the strokes and the major type of stroke being infarction 9 due to blockage of blood vessels)



What are the commonest symptoms of hemorrhagic strokes?

Though sudden headache is common in hemorrhagic stroke, the absence of headache does not exclude a brain haemorrhage and the presence of headache along with stroke symptoms does not confirm a haemorrhage. Only a brain scan can help confirming or excluding a brain haemorrhage. In hemorrhagic strokes, the occurrence of headaches is associated with neurological symptoms of face, arm or leg weakness and speech)



How is hemorrhagic strokes treated?

This is a medical emergency. During the initial phase hemorrhagic strokes are usually treated by conservative medical measures that include stopping blood thinners (anticoagulants and antiplatelets if on any), treating blood pressure and controlling it and in selected cases neurosurgical evacuation of the bleeding clot. After the initial stages of 3-5 days, hemorrhagic strokes are treated the same way as infarction withphysiotherapy and nursing care



Are hemorrhagic strokes more serious than infarction?

This depends on the size of the hemorrhage, the location and progression of the bleed. This has to be answered on an individual case basis



How useful is surgical treatment?

Surgical treatment is reserved for the more severe life threatening bleeds and some bleeds which threaten that situation. Surgical treatment may also be preferred for bleeds in certain locations and this has to be decided in a timely manner by the respective specialist



Ischemic Stroke

Ischemic stroke is the commonest type of stroke and is caused by sudden blockage of blood vessel supplying the brain by a clot within the vessel




How is ischemic stroke treated?

Ischemic stroke is a medical emergency. As this constitutes 85% of all stroke types, all stroke types are considered an emergency. As there is a golden opportunity to treat the ischemic stroke with CLOT BUSTINGTreatment within 4.5 hours, any one with symptoms of stroke should be rushed to the nearest neurological centre for an emergency scan and proceeding further.



What are the symptoms of ischemic stroke?

The classical symptoms are Face, arm or leg weakness, speech problems which happen suddenly or quickly and this may or may not be associated with a headache.



What is a mini-stroke or TIA?

Some patients may develop a warning temporary or brief attack of weakness of face or arm or leg or speech disturbance or loss of vision which rapidly improves and recovers within 24 hours. However, there is no way of being definitive about whether this recovery would happen at the early stages and thus, it is better to treat all patients with face, arm, leg weakness as an emergency and they should be considered for emergency clot treatment.



What are the causes of Ischemic stroke?

Ischemic stroke is caused by blockageof vessels and the clot that blocks teh vessels comes form irregular heart beats, heart valve diseases, clots from neck vessels narrowed due to atherosclerosis (carotid stenosis). Therefore patients with ischemic strokes are evaluated with echo (heart scan), carotid dopplers or angiogram of neck vessels and 24 hour tape recording of the heart( to rule out atrial fibrillation). Other tests done are ECH, Blood sugar, Blood cholesterol and detailed evaluation for lifestyle risk factors are undertaken.



What are lifestyle risk factors?

Smoking, excessive alcohol consumption, sedentary lifestyle, unhealthy diet, diabetes, hypertension, stress are some of the lifestyle factors known to contribute to strokes.