Understanding Hemorrhagic Stroke: Duration And Impact

Hemorrhagic strokes are medical emergencies that occur when a blood vessel in the brain breaks and bleeds. They require immediate treatment and can be fatal. The bleeding disrupts normal circulation in the brain and prevents it from getting the blood and oxygen it needs to survive and function. The stroke also adds extra pressure inside the brain, which can damage or kill brain cells.

The symptoms of a hemorrhagic stroke include thunderclap headaches, light sensitivity, dizziness, trouble understanding or speaking, slurred or garbled speech, one-sided weakness or paralysis, loss of senses, and passing out.

The two types of hemorrhagic strokes are intracerebral hemorrhage (bleeding inside the brain) and subarachnoid hemorrhage (bleeding into the space between the brain and its outer covering).

The duration of recovery and rehabilitation depends on the severity of the stroke and the amount of tissue damage that occurred.

How to recognise the symptoms of a hemorrhagic stroke

A hemorrhagic stroke is a life-threatening medical emergency that requires immediate treatment. It occurs when a blood vessel in the brain ruptures and bleeds, causing severe symptoms that rapidly deteriorate. Recognising the signs and symptoms of a hemorrhagic stroke is crucial to ensure prompt medical attention and improve the chances of survival and recovery. Here are some key symptoms to watch out for:

• Sudden numbness or weakness on one side of the body: This may include the face, arm, or leg.
• Sudden difficulty speaking or understanding speech (aphasia): The person may experience slurred speech or have trouble finding the right words.
• Sudden vision problems: This can include sudden loss of vision or changes in one or both eyes.
• Sudden loss of balance or coordination: Look out for a sudden loss of balance or dizziness.
• Severe headache: A thunderclap or severe headache with no known cause can be an indicator of a hemorrhagic stroke.
• Sensitivity to light (photophobia): The person may be overly sensitive to light and experience discomfort or pain.
• Neck stiffness or pain: This may indicate increased intracranial pressure or inflammation.
• Loss of consciousness: If the person loses consciousness, it could be a sign of a severe stroke.
• Confusion or irritability: Sudden changes in behaviour, such as confusion or irritability, may be a symptom.
• Paralysis: Watch for paralysis on one side of the body, as it could indicate brain damage.
• Difficulty swallowing: This may be a sign of brain stem involvement.
• Fluctuations in heart rate and breathing: Keep an eye on any frequent or unusual changes in heart rate and breathing patterns.

Remember, time is critical in the event of a hemorrhagic stroke. If you or someone you know is experiencing any of these symptoms, call emergency services immediately.

What to do if you think you're experiencing a hemorrhagic stroke

Hemorrhagic strokes are medical emergencies that require immediate treatment. If you think you're experiencing a hemorrhagic stroke, follow these steps:

• Call for emergency medical help: Dial 911 or your local emergency services number immediately. Time is critical in treating hemorrhagic strokes, so don't delay.
• Recognize the signs and symptoms: Be aware of the common signs and symptoms of a hemorrhagic stroke, which can include sudden and severe headaches, light sensitivity, dizziness, slurred speech, one-sided weakness, loss of senses, and loss of balance. Remember the acronym BE FAST:

• Balance: Watch for a sudden loss of balance.
• Eyes: Look for sudden vision loss or changes in one or both eyes.
• Face: Check for a droop on one or both sides of the face.
• Arms: Raise both arms; one arm may sag or be weak if you're having a stroke.
• Speech: Pay attention to slurred speech or difficulty finding the right words.
• Time: Act quickly and call for help immediately.

• Monitor symptoms and track time: If possible, note the time when symptoms started and track their progression. This information can be crucial for healthcare providers in determining the best course of treatment.
• Seek immediate medical attention: Go to the nearest emergency room or stroke center if you're unsure whether you're experiencing a stroke. Don't wait to see if symptoms improve or get worse.
• Prepare for diagnosis and treatment: Healthcare providers will likely perform a neurological exam and tests, such as an electrocardiogram (EKG), to diagnose a hemorrhagic stroke. Be prepared to answer questions about your medical history and symptoms.
• Follow up with rehabilitation: Hemorrhagic strokes often require rehabilitation, including speech therapy, physical therapy, occupational therapy, and cognitive therapy, to help you adjust to any changes in your brain and body. Prioritize your recovery and attend all therapy appointments.
• Practice prevention and risk reduction: Work with your healthcare provider to manage your blood pressure and make lifestyle changes to reduce your risk of another hemorrhagic stroke. This may include maintaining a healthy weight, eating a balanced diet, getting regular physical activity, and avoiding tobacco and recreational drug use.

How to treat a hemorrhagic stroke

Hemorrhagic strokes are life-threatening and require immediate treatment. Here are some ways to treat a hemorrhagic stroke:

Medication

• Clotting support: Medications like vitamin K therapy or prothrombin complex concentrate can be administered to increase the body's ability to stop the bleeding in the brain.
• Blood pressure management: Keeping blood pressure at a safe level can slow the brain bleed and help blood clot and seal the damaged blood vessel. Intravenous (IV) blood pressure medication can be used to maintain a safe blood pressure range.

Surgery

• Hematoma evacuation: Accumulated blood from a stroke puts pressure on the brain tissue. Emergency surgery may be required to remove the excess blood and relieve the pressure on the brain.
• Stroke rehabilitation: Stroke rehab helps patients adjust to changes in their brain and body. This may include speech therapy, physical therapy, occupational therapy, and cognitive therapy.
• Surgical clipping: A tiny clamp is placed at the base of the aneurysm to stop blood flow and prevent it from bursting or bleeding again.
• Surgical AVM removal: Smaller arteriovenous malformations (AVMs) can be removed if they are located in accessible areas of the brain, reducing the risk of hemorrhagic stroke.
• Angioplasty and stents: A catheter is threaded through an artery in the groin to the carotid arteries, and a balloon is inflated to expand the narrowed artery. A stent is then inserted to support the opened artery.

How to recover from a hemorrhagic stroke

Hemorrhagic strokes are medical emergencies that require immediate treatment. They occur when a blood vessel in the brain bursts and can be fatal. The road to recovery from a hemorrhagic stroke is often long and challenging, but with the right care and support, it is possible to regain function and improve one's quality of life. Here are some steps to aid in recovering from a hemorrhagic stroke:

Seek Immediate Medical Attention

It is crucial to call emergency services (e.g., 911 in the US) as soon as you suspect a stroke. The faster you receive treatment, the better your chances of survival and reducing long-term complications. Do not delay, as every second counts.

Initial Treatment and Hospitalization

Once you arrive at the hospital, the medical team will work to stabilize your condition and determine the type of stroke. They may use medications to reduce blood pressure and slow down the bleeding. The typical length of a hospital stay after a stroke is around five to seven days, during which the stroke care team will evaluate the effects of the stroke and develop a rehabilitation plan.

Rehabilitation Therapies

Rehabilitation typically begins as soon as 24 hours after a stroke and involves a team of specialists, including physiatrists, neurologists, physical and occupational therapists, speech-language pathologists, and nurses. The focus of rehabilitation is on restoring your ability to perform activities of daily living (ADL), such as bathing or preparing food. This may include:

• Physical therapy: To strengthen muscles, improve balance, and regain the use of your arms and legs.
• Occupational therapy: To help you safely complete daily tasks, especially those requiring precise body movements.
• Speech therapy: To improve your language and speaking abilities and control the muscles involved in talking, breathing, eating, and swallowing.
• Cognitive therapy: To enhance your memory, concentration, and other mental abilities.

Manage Risk Factors and Complications

It is essential to manage your risk factors to prevent another stroke. High blood pressure is the primary risk factor for hemorrhagic strokes, so maintaining healthy blood pressure levels through medication and lifestyle changes is crucial. Other risk factors to address include excessive alcohol consumption, drug use, high cholesterol, and smoking. Additionally, survivors of hemorrhagic strokes are at an increased risk of cardiovascular problems, such as deep vein thrombosis, pulmonary embolism, and heart attack.

Focus on Your Quality of Life

The impact of a hemorrhagic stroke on your quality of life can be significant, and older survivors often experience more substantial drops in their well-being. It is common to struggle with depression and anxiety following a stroke, so prioritizing your psychological health is vital. Continue to work with your healthcare team and seek support from loved ones to maximize your quality of life during your recovery journey.

Remember, recovery from a hemorrhagic stroke is a gradual process, and improvements may continue to occur even after the first six months. Each person's journey is unique, and your speed of recovery will depend on various factors, including the severity of the stroke, the location of the bleed, and the quality of your rehabilitation process.

How to prevent a hemorrhagic stroke

Hemorrhagic strokes are medical emergencies that require immediate treatment and can be fatal. They occur when a weakened blood vessel in the brain ruptures and bleeds into the surrounding brain tissue. The accumulating blood compresses the brain tissue and disrupts normal circulation, preventing the brain from getting the blood and oxygen it needs.

Maintain Healthy Blood Pressure

High blood pressure is the most common cause of hemorrhagic strokes. It is important to monitor your blood pressure and keep it under control. An ideal blood pressure goal is to maintain a reading of less than 120/80, but this may vary depending on individual circumstances. To help lower blood pressure:

• Reduce salt intake to no more than 1,500 milligrams per day.
• Avoid high-cholesterol foods such as burgers, cheese, and ice cream.
• Consume a diet rich in fruits, vegetables, fish, whole grains, and low-fat dairy.
• Engage in regular physical activity, aiming for at least 30 minutes of exercise per day.
• If needed, take prescribed blood pressure medications as instructed by your healthcare provider.

Achieve and Maintain a Healthy Weight

Obesity and related complications, such as high blood pressure and diabetes, increase the risk of hemorrhagic stroke. Losing weight, even a small amount, can significantly reduce this risk. Work with your doctor to determine a healthy weight goal and develop a personalized weight loss plan. This may include dietary changes and increasing physical activity.

Exercise Regularly

In addition to its benefits for weight loss and blood pressure control, regular exercise is an independent risk reducer for stroke. Aim for at least 30 minutes of moderate-intensity exercise, five days a week. This can include activities such as walking, golfing, or playing tennis. If you can't exercise for 30 minutes at once, break it up into shorter sessions throughout the day.

Limit Alcohol Consumption

Drinking alcohol in moderation is generally considered safe, with an average of one drink per day being acceptable. However, consuming more than two drinks per day sharply increases your risk of stroke. If you choose to drink, limit yourself to one standard-sized drink per day, such as a 5-ounce glass of wine, a 12-ounce beer, or a 1.5-ounce glass of hard liquor.

Treat Underlying Health Conditions

Certain underlying health conditions can increase the risk of hemorrhagic stroke. These include:

• Atrial fibrillation: An irregular heartbeat that can cause clots to form in the heart, which may travel to the brain and lead to a stroke. If you experience symptoms like heart palpitations or shortness of breath, consult your doctor, as you may need to take anticoagulant medication to reduce your stroke risk.
• High blood sugar: This can damage blood vessels over time, making clot formation more likely. Monitor your blood sugar levels and work with your doctor to control them through diet, exercise, and medication if necessary.
• Smoking: Smoking accelerates clot formation and increases plaque buildup in the arteries. Quitting smoking is one of the most effective ways to reduce your stroke risk. Seek advice from your doctor, consider quit-smoking aids, and remember that it may take multiple attempts to succeed.

Frequently asked questions