Doctors call a broken blood vessel in the brain a hemorrhagic stroke. This differs from an ischemic stroke, in which a blood vessel in the brain is blocked, but does not rupture. Hemorrhagic stroke can be a life-threatening condition, and prompt medical attention is crucial to survival. Doctors have several treatments available to them, however, to help a patient survive and recover from a hemorrhagic stroke. Patients can recover from a stroke, and lead a relatively normal life with few limitations--but only if they receive proper medical care quickly. Because of its life-threatening nature, prevention is the best approach to stroke risk.
Symptoms
A stroke is a sudden event, so symptoms tend begin quickly, with no warning. Symptoms may include trouble walking, dizziness, loss of balance or coordination, difficulty speaking or understanding speech, visual disturbances, or a sudden, unexplained headache. Patients may experience a sudden numbness on one side of the face, or a sudden weakness in one side of the body. Patients sometimes attempt to ignore the symptoms or wait for them to pass. This can be a deadly decision -- brain cells are dying every minute a stroke is ongoing. Brain cells far from the site of the bleeding can also be damaged by the swelling and pressure the bleeding causes. The faster a stroke patient receives treatment, the less likely he is to suffer serious, long-term damage to the brain.
Risk Factors
Many of the risk factors for hemorrhagic stroke are under the patient's control. The most significant risk factor is high blood pressure, or hypertension. The National Stroke Association calls high blood pressure "the most important controllable stroke risk factor," noting that it is "responsible for about 60 percent of all cases" of hemorrhagic stroke. Excessive alcohol and drug use and smoking also raise your stroke risk. Certain medical conditions, typically blood-clotting disorders like hemophilia, can contribute as well, and certain blood-thinning medications that reduce clotting can elevate stroke risk. Many patients experience a hemorrhagic stroke when an aneurysm--a weakness in a blood vessel wall that leads to a bulge--ruptures. Aneurysms can be present for years without showing symptoms. Traumatic head injury can also cause a stroke.
Because so many of the risk factors for hemorrhagic stroke are under our control, doctors focus on prevention to reduce the number of deadly strokes. The National Institutes of Health advises, "If you smoke--quit. If you have high blood pressure, heart disease, diabetes, or high cholesterol, getting them under control--and keeping them under control--will greatly reduce your chances of having a stroke."
Diagnosis
When medical personnel suspect that a patient may have suffered a hemorrhagic stroke, nurses will first conduct a neurological assessment. They will ask the patient questions to ascertain whether he is aware of his surroundings, the date and time, where he is and why. They will test the function of the patient's eyes, and test for weakness in arms and legs. Doctors may then order images of the brain in order to confirm the presence of a broken vessel. This is usually a CT scan, the fastest method available.
Treatment
The way doctors choose to treat a ruptured artery in the brain depends on where it is located. Doctors rarely attempt to operate on a rupture deep within the brain tissue, because surgical risks may outweigh benefits. Instead, they will often focus on lowering the patient's blood pressure to limit bleeding, then supporting the patient as the body attempts to recover. They may insert an Extra-Ventricular Drain (EVD) into a part of the patient's brain. This is a temporary device that will help drain fluid from the brain to reduce swelling and pressure. If the site of the bleeding can be accessed safely, doctors may operate to repair the vessel. Surgeons may insert a clip that stops blood flow to the broken vessel, or insert tiny metal coils into the site of the rupture. Blood clots around the coils, closing the broken vessel.
Patients may be observed in an intensive care unit for weeks after a hemorrhagic stroke, and given medicines to prevent blood vessels from spasming, which can complicate recovery.
Prognosis
When stroke victims receive prompt medical treatment, it is possible for them to return to a fairly normal life. But it is difficult, and many don't receive the quick medical attention they need. As a result, hemorrhagic stroke often has devastating outcomes. Injured brain cells do not heal, and the body does not replace them. With rehabilitation, it is possible to relearn some lost functions. But the American Heart Association cautions, "Many survivors never regain all their lost functions. Stroke is a leading cause of serious, long-term disability."
