How to Treat a Hemorrhagic Stroke
Where are the two places bleeding can occur?
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Hello, This is Dr. Joel Stein, from New York Presbyterian Hospital, here with About.com.How does one treat a hemorrhagic stroke? During a hemorrhagic stroke bleeding in the brain can occur in one of 2 places: Either on the surface of the brain or deep inside the brain.If it’s on the surface of the brain, it is most commonly due to a subarachnoid hemorrhage which is typically caused by a rupture of an aneurysm, an enlarged portion of a blood vessel.When it occurs inside the brain, it is called an intracerebral hemorrhage (ICH) and is often caused by high blood pressure.Treatment depends on the type of hemorrhage but close monitoring of the patient’s condition in an intensive care unit is crucial in any event.Once the cause of bleeding has been determined, high blood pressure frequently needs to be reduced via medications. Elevated pressure within the skull can also develop, in which case intravenous medications or a ventriculostomy procedure may be needed to relieve the pressure and let out some of the fluid that bathes the brain.Also, any anticoagulant medication such as Coumadin or aspirin must be immediately stopped.Sometimes surgery is required to stop the bleeding, depending on the amount, cause and location. This may involve a decompressive craniotomy, where the surgeon opens up the patient’s skull to reduce the pressure inside. For ruptured aneurysms, surgery commonly involves placing a clamp at the base of the aneurysm to prevent further leakage.Coil embolization is a less invasive treatment, in which a catheter containing a coil is inserted into an artery to reach the aneurysm and create a seal that will prevent rupture.Other courses of treatment could include radiosurgery where radiation is used to shrink a collection of abnormal blood vessels known as an AVM.Even after treatment is administered, possible complications need to be monitored:Oftentimes medication such as Heparin will be used preventatively. To find out more, go to About.com
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