Broken Blood Vessels in the Brain
A broken blood vessel in the brain is known as a hemorrhagic stroke. Roughly 10 to 15 percent of all first strokes are the result of a broken blood vessel in the brain, according to the American Heart Association and American Stroke Association Stroke Council 1.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Arterial bleeds generally have worse outcomes than venous bleeds, but either form can be life-threatening.
With prompt treatment, it is possible to survive a hemorrhagic stroke and regain near-normal quality of life. Swift medical attention is crucial to survival.
Symptoms
A hemorrhagic stroke usually occurs without warning.
Patients typically experience a sudden, intense headache.
They may feel weakness or numbness on one side of the face or body. Other possible symptoms include loss of balance; loss of coordination; difficulty walking; trouble speaking or understanding speech; and vision problems.
Prompt treatment is crucial if you experience symptoms of a hemorrhagic stroke. Without a constant blood supply, brain cells quickly die. Even brain cells far from the broken blood vessel may be damaged by swelling.
The brain cannot regrow dead cells, so function lost in a stroke are often never recovered. The faster a patient receives medical treatment, the more likely he is to survive and retain important brain functions.
- A hemorrhagic stroke usually occurs without warning.
- Even brain cells far from the broken blood vessel may be damaged by swelling.
Risk Factors and Prevention
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Because hemorrhagic stroke can lead to death or irreversible disability, prevention is vital.
Many of the risk factors for hemorrhagic stroke, however, are controllable.
The most important modifiable risk factor is high blood pressure, or hypertension.
According to the National Stroke Association, hypertension contributes to 60 percent of all hemorrhagic strokes 1. Smoking, excessive alcohol use and illicit drug use also raise stroke risk. The National Institutes of Health states that people can cut their stroke risk significantly by reducing their alcohol intake, quitting smoking and controlling high cholesterol.
Some risk factors are outside the patient's direct control. Certain blood disorders, such as hemophilia and sickle-cell disease, increase the risk for a hemorrhagic stroke. People with these illnesses can still reduce their risk by carefully controlling their blood pressure and making healthy lifestyle choices.
- Because hemorrhagic stroke can lead to death or irreversible disability, prevention is vital.
Diagnosis
When a patient enters the hospital with symptoms suggestive of a hemorrhagic stroke, the medial personnel perform a neurological assessment. This involves having the patient perform simple tasks and asking questions to determine whether the patient is aware of her surroundings. If a stroke seems likely, doctors will order images of the brain to confirm the presence of a bleed.
Treatment
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Doctors have several tools at their disposal for treating a ruptured blood vessel. What treatment tool they choose depends largely on where the bleed is located.
Surgeons often will not attempt to operate on a rupture deep within brain, since the surgery may cause too much tissue damage.
In such cases, treatment focuses on reducing blood pressure to limit bleeding and supporting the patient's body as it attempts to repair itself. Surgeons may insert an extraventricular drain, a temporary device that helps drain fluid to reduce pressure on the brain.
If the site of the bleeding is not deep within the brain, surgeons may recommend operating.
They can sometimes clip the broken vessel, stopping blood flow to the rupture site. Alternatively, they may insert a tiny coil into the rupture site, which promotes blood clotting, helping to close the torn vessel.
- Doctors have several tools at their disposal for treating a ruptured blood vessel.
- Surgeons often will not attempt to operate on a rupture deep within brain, since the surgery may cause too much tissue damage.
Prognosis
With prompt medical attention, people who have suffered a hemorrhagic stroke may recover and return to a life with few limitations. Recovery commonly requires months of rehabilitative therapy. People who do not receive swift treatment or suffer from a severe brain bleed, however, may be left with serious, permanent loss of certain cognitive or physical functions.
Related Articles
References
- American Heart Association: Hemorrhagic Strokes (Bleeds)
- National Institute of Neurological Disorders and Stroke: Stroke
- Stroke: Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults
- Khaku AS, Hegazy M, Tadi P. Cerebrovascular Disease (Stroke) [Updated 2019 Aug 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- Panuganti KK, Tadi P, Lui F. Transient Ischemic Attack. [Updated 2019 Mar 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- Correia M, Fonseca AC, Canhão P. Short-term outcome of patients with possible transient ischemic attacks: a prospective study. BMC Neurol. 2015;15:78. Published 2015 May 13. doi:10.1186/s12883-015-0333-1
- Al-Qazzaz NK, Ali SH, Ahmad SA, Islam S, Mohamad K. Cognitive impairment and memory dysfunction after a stroke diagnosis: a post-stroke memory assessment. Neuropsychiatr Dis Treat. 2014;10:1677–1691. Published 2014 Sep 9. doi:10.2147/NDT.S67184
- Donkor ES. Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life. Stroke Res Treat. 2018;2018:3238165. Published 2018 Nov 27. doi:10.1155/2018/3238165
- Nadarajan V, Perry RJ, Johnson J, Werring DJ. Transient ischaemic attacks: mimics and chameleons. Pract Neurol. 2014;14(1):23–31. doi:10.1136/practneurol-2013-000782
- Abbott AL, Silvestrini M, Topakian R, et al. Optimizing the Definitions of Stroke, Transient Ischemic Attack, and Infarction for Research and Application in Clinical Practice. Front Neurol. 2017;8:537. Published 2017 Oct 18. doi:10.3389/fneur.2017.00537
- Boehme AK, Esenwa C, Elkind MS. Stroke Risk Factors, Genetics, and Prevention. Circ Res. 2017;120(3):472–495. doi:10.1161/CIRCRESAHA.116.308398
- Centers of Disease Control and Prevention. Cerebrovascular Disease or Stroke. National Center for Health Statistics. June 2019 cdc.gov
- Khare S. Risk factors of transient ischemic attack: An overview. J Midlife Health. 2016;7(1):2–7. doi:10.4103/0976-7800.179166
- Ustrell X, Pellisé A. Cardiac workup of ischemic stroke. Curr Cardiol Rev. 2010;6(3):175–183. doi:10.2174/157340310791658721
- McGarry BL, Jokivarsi KT, Knight MJ, Grohn OHJ, Kauppinen RA. Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia. J Vis Exp. 2017;2017(127):55277. doi:10.3791/55277
- Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2018;49(3):e46-e110.
- Fuentes B, Gállego J, Gil-nuñez A, et al. Guidelines for the preventive treatment of ischaemic stroke and TIA (I). Update on risk factors and life style. Neurologia. 2012;27(9):560-74.
- Advances in stroke over the past decade, Silver B, Rhode Island Medical Journal, May 2014
Writer Bio
Robin Tucker covers health for several online publications. She is a registered nurse with experience in labor and delivery, critical care, neurology and neurosurgery, and works in Labor and Delivery at a large, urban teaching hospital. Tucker is completing her Master of Science in nurse-midwifery at Frontier Nursing University and holds a Bachelor of Science in nursing from George Mason University.