Hemorrhagic stroke (intracerebral)

Question 1

what is cerebral hemorrhagic stroke?

Answer 1

Is a stroke cause by hemorrhage in the bran parenchyma. 10 % of strokes.
we have two types:
1. intraparenchymal - bleeding in brain tissue. This is the ore serious type causes increased intracranial pressure.
2. intreventicular- extends into ventricles.

Question 2

Cause of cerebral hemorrhagic stroke?

Answer 2

1. Hypertension - which can cause hyaline atersosclerosis and microaneurysm.
2. head trauma.
3. Ateriovenous malformation.
4. Tumors ( hemangioma)
5. Eclamsia
6. drugs ( ampthetamin, cocaine)
7. Can be secondary to ischemic stroke.

Question 3

Risk factors of cerebral hemorrhagic stroke?

Answer 3

Hypertension
>55 years , Male
Diabetes, liver disease
smoking. Heavy alcohol consumption

Question 4

symptoms of cerebral hemorrhagic stroke?

Answer 4

*specific symptoms depends on the location of the bleeding.
* symptoms caused by increased ICP
TIA - like symptoms ( headache, vometing, alterd mental status, seizures, marked HT)

Question 5

Diagnosis and treatment of Cerebral hemorrhagic stroke?

Answer 5

Diagnosis: non contrast CT will show the bleeding as hyperdense ( white) , MRI and angiography can also be done.

Treatment:
* check PTT / INR
Hypertension: antipypersensive
Increased ICP: mannitol, corticosterioids.
Seizures: phenytoin, levetiracetam
*Frozen plasma. Acetaminophen ( relive headaches)
Surgery: Craniotomy ( if hematoma >3cm , hemorrhage in young people )