Hemorrhagic Stroke: Let's talk about this dangerous condition!

Oh, imagine what would happen if a tiny blood vessel inside your head, that is, in your brain, suddenly burst? It's really scary to think about, isn't it? This is what we call a 'hemorrhagic stroke ', a condition of paralysis caused by a blood vessel bursting inside the brain and bleeding. This is a really life-threatening, emergency situation. "Hemorrhage" is a word used by doctors, simply put, for bleeding from somewhere inside the body.

When blood starts to flow into the brain in this way, the brain does not get enough blood or oxygen. So the brain cannot function. Not only that, but the extra pressure inside the head can damage brain cells and even kill them. This type of stroke (hemorrhagic stroke) is very serious because the symptoms appear quickly and get worse quickly. If you do not get medical treatment quickly, you can cause permanent brain damage and even death. If you think you or someone you are with is having a stroke , call 911 (or your local emergency number) immediately. The most important thing is to get the patient to the hospital as soon as possible and start treatment. Every second counts here.

What are the symptoms of a 'hemorrhagic stroke'?

When a hemorrhagic stroke occurs, one or more symptoms may appear at once. Here are some of them:

• Thunderclap headaches: A sudden, unbearable, severe headache.
• Photophobia: Eyes become blue when exposed to bright lights or sunlight.
• Dizziness or vertigo.
• Difficulty understanding what others say or difficulty speaking (Aphasia).
• Words become slurred and speech becomes unclear (Dysarthria).
• One-sided weakness or paralysis.
• Sense organs such as sight, hearing, and touch lose their function.
• Neck stiffness, difficulty bending.
• Vomiting and nausea .
• The fit is coming (Seizures).
• Passing out or fainting.
• Coma.

What are the warning signs of a 'hemorrhagic stroke'?

This paralysis can cause a variety of symptoms. To find out if you or a loved one has this condition, BE FASTRemember the acronym. It's made by combining the first letters of a few English words.

• B - Balance : Watch for sudden loss of balance. As if you can't stand up straight.
• E - Eyes: See if there is a sudden loss of vision in one or both eyes, and if there is a change.
• F - Face: Try smiling. See if one side or both sides of your face appear to be drooping.
• A - Arms: Try to raise both arms. If you are paralyzed , you may not be able to raise one arm, fall down, and become very weak.
• S - Speech: See if the speech is slurred or if it is difficult to get the words right.
• T - Time: Time is of the essence - seek help immediately. If possible, look at a watch or phone and note the time your symptoms started. Telling a doctor when your symptoms started can help them decide what treatment is best for you.

Remember, if you have any of these BE FAST signs, it could be a stroke. So don't waste time and get to a hospital right away.

Let's also learn about a mini-stroke (Transient Ischemic Attack - TIA).

Sometimes there is a condition called a 'mini-stroke', which doctors call a 'transient ischemic attack' ( TIA ) . This is like a stroke, but the symptoms disappear after a while. But this is a very serious warning ! A person who has had a TIA is at a very high risk of having a major stroke in the near future. Therefore, it is essential for a person who has had a TIA to seek medical treatment as soon as possible.

What are the causes of this 'hemorrhagic stroke'?

Simply put, anything that damages the blood vessels in your brain and causes them to burst can cause this. High blood pressure (hypertension) is the main and most common cause of this. This risk is especially high if your blood pressure is very high, or if it has been uncontrolled for a long time.

Here are some more reasons:

• Brain aneurysms are blood vessels in the brain that bulge or bulge like balloons. These can weaken and burst suddenly.
• Brain tumors.
• Moyamoya disease: In this, the main blood vessels supplying blood to the brain become blocked, and small new blood vessels form, but they are very weak.
• Cerebral amyloid angiopathy: In this, a protein is deposited in the walls of the blood vessels in the brain, weakening them.
• Head injuries.
• It has been found that COVID -19 infection can sometimes be a cause of this.
• Sometimes, after an ischemic stroke caused by a blood clot in the brain, bleeding can begin in that area.

Are there types of 'hemorrhagic stroke'?

Yes, there are two ways that blood can flow into the brain like this:

1. Intracerebral hemorrhage: This is when a blood vessel inside the brain bursts. The blood then collects inside the brain tissue and creates pressure. Think of it like a water balloon bursting inside.

2. Subarachnoid hemorrhage: Our brain is surrounded by a thin protective membrane called the arachnoid membrane. The space between this membrane and the brain is called the subarachnoid space. If a blood vessel that passes through this ruptures, the blood collects in this space. This puts pressure on the brain from the inside of the skull.

Who is at higher risk of developing these?

Anyone can have a hemorrhagic stroke, but the following people are at higher risk:

• People over 65 years of age.
• People who smoke (or use other types of tobacco).
• People who use illegal drugs.

Also, if you have any of these health conditions that affect your circulatory system, your risk of stroke is higher:

• High blood pressure (Hypertension).
• Alcohol use disorder.
• High cholesterol (Hyperlipidemia).
• Migraine headaches, especially those with aura.
• Diabetes (Diabetes Mellitus).

How do doctors recognize this?

A doctor diagnoses a hemorrhagic stroke by performing a neurological exam and performing tests such as:

• CT scan: This is the only way to quickly check for bleeding in the brain.
• Blood tests: Check for things like blood clotting problems and sugar levels.
• ECG (Electrocardiogram - EKG): Checks the functioning of the heart.
• MRI: This helps to see the brain in more detail.

What are the main treatments for a hemorrhagic stroke?

The two main treatments for this are medications and surgery.

Medications for 'hemorrhagic stroke'

Doctors use a variety of medications to treat this condition. They work in two main ways:

1. Speeding up blood clotting: Many people think that blood clots are a bad thing (in fact, blood clots can be dangerous). But blood clotting is our body's natural way to stop bleeding. Doctors can give you medications like Vitamin K therapy or Prothrombin complex concentrate to help your body stop bleeding in the brain.

2. Control your blood pressure: Keeping your blood pressure at a safe level can help reduce bleeding in the brain. It also helps prevent blood clots from forming in damaged blood vessels. Your doctor may start you on IV (intravenous) blood pressure-lowering medications.

Surgery for 'hemorrhagic stroke'

The blood that collects due to a stroke puts a lot of pressure on the brain tissue around the bleeding blood vessel. If the pressure inside the skull (intracranial pressure) increases too much, you may need emergency surgery. The surgeon will also remove the accumulated blood and reduce the pressure on the brain.

Stroke Rehabilitation

Rehabilitation is an important part of treating a hemorrhagic stroke. It helps you adjust to the changes in your brain and body. You may need to regain lost abilities or learn to live with new disabilities. You may need one or a combination of the following treatments:

• Speech therapy: Restore or improve your language and speaking skills. This helps control the muscles that help you speak, breathe, eat, and swallow.
• Physical therapy: Strengthen muscles, improve balance, and restore function in arms and legs.
• Occupational therapy: Helps you perform your daily tasks safely, especially tasks that require fine movements.
• Cognitive therapy: Helps improve memory, attention, and other mental abilities.

Can a hemorrhagic stroke be prevented?

Maintaining a healthy blood pressure is the most important way to prevent a hemorrhagic stroke. If you have high blood pressure, your doctor can help you control it. They can advise you on medications and changes you need to make to your daily routine.

Other things are:

• Keep other medical conditions you have (such as diabetes and cholesterol) under control.
• Eat more healthy foods and maintain a healthy weight that suits you.
• Exercise well.
• Have a medical checkup every year (or as directed by your doctor).
• If you smoke, stop it immediately.

What is the survival time after a 'hemorrhagic stroke'?

It's difficult to say exactly how long you can live after a hemorrhagic stroke and what the recovery rate is, because everyone's body and health status are different.

Paralysis can be fatal and cause permanent disability, but there is no one-size-fits-all recovery schedule or outlook.

A hemorrhagic stroke is more likely to be fatal than an ischemic stroke, which is caused by a blood clot in the brain. But that doesn't mean you will definitely have a worse outcome than others.

Everyone's body responds differently to a stroke. What you can expect (prognosis) after a stroke depends on several factors:

• Which parts of the brain were affected?
• How quickly you received treatment.
• Your overall health.

Your doctor will tell you what to expect. They will help you set your recovery goals and expectations based on your health and condition.

How do I take care of myself after a hemorrhagic stroke?

Recovering and rehabilitating after a stroke is not easy. Once you and your doctor have developed a treatment plan, follow it as closely as possible. In general:

• Take your medication correctly: Taking your medication as prescribed by your doctor will help your body heal. Controlling your blood pressure is extremely important.
• Go to your rehab and other treatment appointments regularly: Tell your therapists if anything is making you feel uncomfortable or unsafe. Rehab is hard, but you don't have to be in constant pain or discomfort.
• Think about your mental health: Depression and anxiety are common after a stroke. Feeling sad or upset doesn't mean you're weak or a failure. Your mental health is just as important as your physical health. If you need help talking about things during your recovery, talk to your doctor or a mental health counselor .

When should I go to an Emergency Treatment Unit (ETU) ?

If you feel like you are having another stroke, call 911 (or the emergency number) immediately. Another stroke is very likely to be fatal or cause serious complications. Don't delay in seeking help.

A person who has had a stroke is also at risk of developing other serious complications, such as:

• Pulmonary embolism.
• A heart attack.
• Blood clots in the deep veins of the legs (Deep vein thrombosis - DVT).

If you think you have symptoms of any of these complications, call emergency services immediately or go to an emergency room.

What questions should I ask my doctor?

• How do I take my medication?
• How long will I need therapy?
• What changes do I need to make in my daily life?
• What warning signs should I look out for that indicate another stroke is coming?
• When should I come see you again?

A hemorrhagic stroke can have a big impact on your life. Anything that can permanently affect your brain is scary. If you think you're having symptoms of a stroke, get help right away. The sooner a doctor can diagnose and treat the condition, the better.

Once you are in a safe, stable state, rehabilitation begins. It's hard work, but it's worth it. Don't ignore your feelings, and share your frustrations with your doctors and therapists. Your recovery may come in small steps, but don't forget to celebrate each success you achieve.

Take-Home Message

A hemorrhagic stroke is a very dangerous, emergency medical condition caused by a burst blood vessel in the brain. The main cause of this is high blood pressure.

Remember the acronym BE FAST (Balance, Eyes, Face, Arms, Speech, Time) to recognize the symptoms quickly. If you have any of the symptoms , go to the hospital immediately.

Treatment includes medications and surgery. Rehabilitation (speech, physical, occupational, cognitive therapy) is very important in recovery.

To prevent it, control your blood pressure, follow a healthy lifestyle, and avoid smoking.

Don't forget, in a situation like this, every second counts. Taking quick action can save a life and prevent serious injuries.

` Paralysis, Bleeding in the Brain, Hemorrhagic Stroke, High Blood Pressure, Stroke Symptoms, Stroke Treatment, Rehabilitation