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A hemorrhagic stroke occurs because of a leak or rupture of a blood vessel in the brain. There are two types of stroke, hemorrhagic and ischemic , which occurs when a blood vessel to the brain is blocked by a clot. Hemorrhagic stroke represents about 15% of all strokes, yet is responsible for more than 30% of stroke deaths.
Stroke, which is sometimes called “brain attack,” is the fifth most leading cause of death for Americans and is the leading cause of adult disability. Stroke is more common in women than in men. Each year approximately 800,000 Americans will suffer a stroke and 130,000 will die as a result.
There are two types of hemorrhagic stroke:
Wellstar physician’s are experts at diagnosing and treating ischemic and hemorrhagic stroke.
Wellstar Kennestone Hospital located in Marietta offers a full service neuroscience program for stroke and other neurological emergencies. Kennestone is one of the few comprehensive cerebrovascular neurosurgery programs in the region, offering state-of-the-art procedures for both open and closed vascular and endovascular procedures for stroke and carotid artery disease. Kennestone is proud to offer the highest level of specialized care in order to meet the needs of our region and beyond. In addition, Wellstar Kennestone offers a CARF certified in-patient Rehabilitation program on campus.
Wellstar participates in clinical trials that let patients participate in the latest stroke research and take advantage of emerging drugs and treatments. As well, we are now part of the Mayo Clinic Care Network. This provides our doctors and other specialists with access to Mayo-reviewed medical information and guidelines.
Call 911 immediately if you believe you or someone else is having a stroke! Think of the acronym FAST to remember symptoms.
F- Facial drop or uneven smile
A- Arm/leg numbness or weakness, loss or coordination or balance
S- Slurred speech, difficulty speaking or understanding simple commands
T- Time to call 911 and get to the hospital immediately; note the time so you'll know when the first symptoms appeared
In addition to the F.A.S.T. symptoms (facial droop, arm/leg weakness/loss of coordination or balance, slurred speech and difficulty speaking or understanding simple commands), other signs of a stroke include:
Not all symptoms will be apparent with every stroke. If any of these symptoms appear, get immediate medical help—call 911
Some risk factors for stroke are the same for men and women:
Primary prevention refers to steps taken to prevent a first stroke. Talk with your doctor about appropriate primary prevention methods like taking blood pressure medication as prescribed, managing Diabetes as well as stress. Other prevention methods include lifestyle changes such as:
Your Wellstar physician may recommend certain medications and steps to control high blood pressure and/or manage atrial fibrillation in high-risk patients.
Surgical treatment may be used to stop the bleeding in a hemorrhagic stroke. If the bleed is caused by a ruptured aneurysm, a metal clip may be placed surgically at the base of the aneurysm to secure it. Some endovascular (minimally invasive) surgical procedures may be recommended. These involve the use of a catheter introduced through the arm or leg, then guided to the aneurysm or other malformation. The catheter deposits a coil or other mechanism to prevent rupture.
Immediate medical attention is essential following a stroke. Once a patient arrives at the hospital Wellstar physicians will use a computer-imaging test to determine the type of stroke and the area of the brain affected. If doctors suspect a blood vessel abnormality they may perform an angiogram. This is an X-ray test that provides a picture of the blood vessels in the brain.
Your Wellstar physician will ask about symptoms, their timing, what you were doing when they began and whether you still have them. The doctor will want to know about all medications you take, whether you’ve had a head injury and any family history of stroke or heart disease.
Wellstar physicians use various brain imaging techniques to determine if you are having/had a stroke, the type and where it is occurring. Imaging methods include:
Treating a hemorrhagic stroke involves controlling bleeding and reducing pressure on the brain. Once bleeding stops treatment includes bed rest while the body reabsorbs the blood, as it would with a large bruise. In some cases surgery may relieve the pressure of blood on the brain or repair the leaking vessel.
Treatment of ICH involves medical and surgical techniques that vary according to the cause and size of the stroke. When ICH is caused by high blood pressure, doctors try to reduce the blood pressure, then address the swelling or pressure that build up inside the head after the blood vessel ruptures. Surgery may be needed to limit the damage to brain cells.
Treatment of SAH targets the cause of bleeding and its complications. Ruptured aneurysms are usually repaired through surgery to clip the aneurysm, or to treat it from inside the vessel. Operating on the aneurysm from the inside (embolization) is done by guiding a small metal coil through the brain artery until it reaches the aneurysm. There, the coil allows for a clot to form and to prevent more blood from entering.
Vasospasm is a condition in which vessels become irritated by blood and begin to spasm. Treatment for this condition includes the use of the oral medication nimodipine, or by closely monitoring the pressure, volume and concentration of blood in the brain.
After initial treatment your doctor will treat your risk factors, including by recommending lifestyle changes like quitting smoking, following a healthy diet, maintaining a healthy weight and being physically active. If these are not enough, medicines may be prescribed to control the risk factors.
Stroke is a leading cause of disability in adults and places a great burden on patients and their families. However, even if portions of the brain are lost in a stroke, patients can benefit from excellent therapies.br>
After emergency treatment, your Wellstar neurologist will work to develop an individualized rehabilitation program with the specialists at the Wellstar Kennestone Outpatient Neuro-Rehabilitation program. The program serves patients in the acute care hospital setting, inpatient rehab unit and outpatient settings.
There are four locations—Cobb Hospital, Kennestone Hospital, Douglas Hospital (speech only) and Windy Hill Hospital (speech only).
Physical therapists, occupational therapists and speech therapists address issues including:
If the stroke has damaged the parts of the brain responsible for speech, it may be necessary to relearn language skills. Fortunately the brain has a great ability to learn and adapt, so other portions of the brain can be trained to take over lost communication function. With time, survivors of strokes that impact speech usually regain some or all previous language ability.
Many stroke patients also require psychiatric or psychological care including counseling and medication to help with depression, frustration and anger resulting from their strokes. Under the care and treatment of our Physiatrists and extended care team, all aspects of the stroke survivor is addressed.
Wellstar offers smoking cessation programs that educate people about smoking risks, encourage behavior modification to help minimize smoking urges and offer numerous coping strategies. Several different methods for changing smoking behavior are explored so that individuals learn approaches that work best for them.