Brain Stroke - Treatment for Haemorrhage

What is Stroke?

A stroke is referred to as the condition when the supply of blood to any particular part of the brain is reduced or interrupted which in turn deprives the tissues of the brain of oxygen and essential nutrients. Within a few minutes of the stroke, the cells of the brain begin to die out resulting in the need of an emergency treatment which can save the brain from being damaged and further potential complications. An extremely prompt treatment is crucial for saving the life of a patient to whom the stroke has occurred.

Types of Stroke and Its Causes

In general, there are three main types of stroke which are as detailed below.

Ischemic Stroke
More than about 80 per cent of the stroke that occurs is ischemic stroke which is caused by the arteries of the brain being blocked or narrowed resulting in the reduction of flow of blood. Ischemic stroke is again divided into two types which are as follows.

1. Thrombotic stroke – Thrombotic stroke is caused when a blood clot is formed is any one of the arteries that supply blood to the brain. This clot is formed as a result of fatty deposits in the arteries which hinders the flow of blood ultimately resulting in a stroke.
2. Embolic stroke – An embolic stroke occurs at the time when a blood or other debris forms at some distance from the brain most commonly in the heart which is swept through the bloodstream resulting in the narrowing of the brain arteries.

Haemorrhagic Stroke
A haemorrhagic stroke occurs at the time when a blood vessel in the brain is ruptured which are caused due to the following.

• Uncontrollable high blood pressure
• Overuse of blood thinners
• Presence of some weak spots in the blood vessels

In a few of the cases, haemorrhagic stroke is caused by the bursting of the brain and spills into the surrounding tissue of the brain. The different types of haemorrhagic stroke include:

1. Intracerebral haemorrhage – In this case, a blood vessel in the brain bursts and spills into the surrounding tissue of the brain results in the damaging of the brain cells. The cells are deprived of blood and finally get damaged. High blood pressure vascular malformations, trauma and use of medications that results in thinning of the blood are the general causes of intracerebral haemorrhage.
2. Subarachnoid haemorrhage – In this case, an artery on the surface of the brain or near it bursts and spills blood into the space between the surface of the brain and skull. The common causes of subarachnoid haemorrhage are bursting of a small sack or the shape of a berry called aneurysm.

Transient ischemic attack (TIA)
A transient ischemic attack is sometimes referred to as a mini-stroke which results in a temporary decrease in the supply of blood to a specific part of the brain. In this case, a clot is formed as in case of an ischemic stroke but there is no permanent damage to the tissue and the symptoms do not last long.

Symptoms to Look for
It is quite important to have a close look at the signs and symptoms of stroke which would be extremely helpful for proceeding with the steps of diagnosis and treatment. Some of the most common symptoms for stroke are as listed below.

• A sudden headache ranging from mild to severe which is accompanied by dizziness, nausea, vomiting or altered consciousness indicates that a stroke might have occurred.
• Numbness or paralysis of the face, arm or legs might indicate the occurrence of a stroke. This happens suddenly and usually takes place on one side of the body.
• Having trouble to see in both of the eyes or in one eye is a sign of a stroke. The vision might be blurred or completely blackened or a double vision indicates the occurrence of a stroke.
• Having a difficulty in walking or tumbling is an important sign to watch out for the occurrence of a stroke.
• Another important symptom of the stroke is having a difficulty in speech as well as understanding. The affected individual might experience confusion or slurring in the speech.

Apart from the major symptoms that are mentioned above, there are a number of other minor signs and symptoms of occurrence of a stroke.

Treatment Procedures
There are a number of treatment procedures followed by the expert doctors which are as discussed below.

Ischemic Stroke
In case of an ischemic stroke, the following emergency treatment along with proper medications are usually applied.

• Intravenous injection of tPA or tissue plasminogen activator is given to the patients burst the clot that is occurred as a result of the stroke.
• Emergency endovascular procedures are done by the doctors for the effective treatment of ischemic stroke This includes medicines which are directly delivered to the affected region of the brain. Also, the doctors remove the clot with the help of a stent retriever.
• Carotid endarterectomy, angioplasty and stents are some of the other emergency procedures done by the doctors as per requirement.

Haemorrhagic Stroke
For haemorrhagic stroke, the treatment procedure is focused on controlling of the bleeding occurring in the brain and involves the following.

• Surgical repair of the blood vessels is carried out by the doctors for taking care of the abnormalities of the blood vessel that includes surgical clipping, endovascular coiling, embolization, surgical removal of AVM, and stereotactic radiosurgery.

In an addition to this, the specialised doctors for stroke carry out procedures like clot evacuation and hemicraniectomy which are based on the condition of the severity of the stroke that has taken place and the condition of the patient. An effective and timely treatment in case of a stroke can help the affected individual to get cured steadily without causing any further damage to cells of the brain.

Authored By Dr Somesh Vanchilingam - Neuro Specialist, Thanjavur

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