Hemorrhagic Stroke: Causes and Effects

• The brain receives 15-20% of the body's blood supply, despite making up only 2% of body weight, reflecting its high metabolic needs.
• The brain cannot store oxygen or glucose, making it highly susceptible to blood flow interruptions.
• A blood flow disruption of just 3-5 minutes can cause irreversible brain cell damage.
• The fibrovascular system maintains consistent blood flow to the brain, even under varying conditions.

Hemorrhagic Stroke

• Hemorrhagic strokes involve bleeding that damages brain tissue.
• A blood vessel ruptures, causing bleeding into or around the brain.
• Blood is toxic to brain cells, causing damage.
• Accumulated blood creates pressure, damaging surrounding tissues.
• The affected area loses its blood supply, causing further damage.
• Intraerebral hemorrhage: blood vessel rupture within the brain tissue.
• Subarachnoid hemorrhage: bleeding in the space between the brain and surrounding membranes.

Causes of Hemorrhagic Stroke

• Hypertension weakens vessel walls over time.
• Aneurysms are weakened areas of blood vessel walls that can rupture.
• Arteriovenous malformations are abnormal tangles of blood vessels prone to bleeding.
• Blood-thinning medications can increase hemorrhagic stroke risk, especially at high doses.

Modifiable Lifestyle Factors

• Smoking doubles stroke risk by promoting atherosclerosis, increasing blood clot formation, and raising blood pressure.
• Physical inactivity contributes to obesity, hypertension, and diabetes, all stroke risk factors.
• A diet high in sodium, saturated fats, and processed foods increases stroke risk.
• Excessive alcohol raises blood pressure and can trigger atrial fibrillation.
• Chronic stress may contribute to stroke risk through effects on blood pressure and inflammation.
• Positive changes like quitting smoking, increasing activity, improving diet, limiting alcohol, and managing stress significantly reduce risk.

Recognizing a Stroke Using the FAST Method

• F (Face): Ask the person to smile; one side may droop if having a stroke.
• A (Arms): Ask the person to raise both arms; one may drift downwards if having a stroke.
• S (Speech): Ask the person to repeat a phrase; speech may be slurred or impossible if having a stroke.
• T (Time): If any signs are observed, call emergency services immediately.
• Time is critical; every minute without treatment results in the death of nearly 2 million brain cells.

Additional Warning Signs of Stroke

• A sudden, severe headache with no known cause.
• Vision problems, including trouble seeing in one or both eyes.
• Dizziness and balance issues should not be dismissed.
• Coordination problems or clumsiness indicate brain region damage.
• Sudden confusion or trouble understanding speech are critical symptoms.
• Symptoms vary depending on the affected brain region.
• Posterior circulation strokes affect the brainstem and cerebellum, presenting differently than FAST symptoms.
• Be aware that not all strokes present with typical FAST symptoms.

Stroke Rehabilitation

• Rehabilitation begins as soon as the patient is medically stable.
• Physical therapy improves mobility, strength, balance, and coordination via exercises.
• Occupational therapy helps patients relearn daily activities.
• Adaptive techniques and specialized equipment aid patients in overcoming limitations.
• Both therapies use neuroplasticity principles.
• Repeated practice helps the brain form new connections.
• Early, intensive rehabilitation improves outcomes and independence.

Long-Term Challenges for Stroke Survivors

• Physical effects include hemiparesis, spasticity, sensory changes, and vision problems.
• Psychological and cognitive challenges include post-stroke fatigue, affecting up to 70% of survivors.
• Physical adaptations include home modifications and assistive devices.
• Psychological adaptation involves coping strategies, support groups, and counseling.

Stroke Recovery Timeline

• Recovery isn't linear; improvements can continue for years.
• Initial recovery is rapid; many achieve 50% of their eventual recovery within 3 months.
• By 1 year, recovery typically reaches 80%.
• After 2 years, recovery often reaches 95%, with smaller improvements continuing.

Stroke Prevention Strategies

• Prevention requires individual strategies and public health initiatives.
• Individual strategies include blood pressure control, smoking cessation, diabetes management, and cholesterol reduction.
• Diet improvements, regular physical exercise, and limited alcohol consumption are helpful.
• Consistent implementation of these strategies helps maintain healthy blood flow and vessel integrity.
• Public health initiatives include educational campaigns, risk factor screening, and improved emergency response systems.
• Community-based interventions targeting high-risk populations have proven successful.
• Comprehensive prevention combines individual strategies with public health initiatives.