Friday, March 28, 2008

Treatments for Hemorrhagic Strokes (Thuc)

Hemorrhagic stroke is less common but more frequently fatal than ischemic stroke. Hemorrhagic stroke has two main types. Each is named according to the part of the brain affected by the bleeding:

* subarachnoid hemorrhage refers to bleeding that occurs in the space between the surface of the brain and the skull.
* intracerebral hemorrhage refers to bleeding that occurs within the brain tissue.

Treatment Options

In a hemorrhagic stroke, treatment is based on the underlying cause of the hemorrhage and the extent of damage to the brain.

Immediate treatment for hemorrhagic strokes is best administered in an intensive care unit, where medical personnel can immediately detect any complications. Sometimes persons experiencing a hemorrhagic stroke develop irregular breathing patterns or stop breathing. Medical intervention may be needed to protect the airway and avoid choking or inhaling secretions into the lungs if a patient is unconscious or semiconscious.

In addition to basic life support, treatment includes:

If high blood pressure causes a hemorrhagic stroke, antihypertensive drugs are administered to bring blood pressure down. In addition, brain bleeding may cause swelling of surrounding brain tissue, and this may require therapy with drugs called hyperosmotic agents (mannitol, glycerol, and hypertonic saline solutions).

If the hemorrhage resulted from the use of anticoagulants, such as Coumadin or heparin, these medications are discontinued immediately. Medications may be given to reverse the effects of these anticoagulants to reduce bleeding.

In addition, pain relievers and antianxiety medications may relieve the headache that often accompanies hemorrhagic stroke. Medications may be needed to prevent or treat seizures.
Surgery and other procedures

Surgery or another procedure may be needed to save a patient’s life or to improve the chances of meaningful recovery. The type of surgery depends upon the cause of the bleeding, and is usually divided into three categories:

Aneurysm Treatments

* Aneurysm clipping
Aneurysm clipping involves opening the skull to expose the aneurysm and placing a clip to prevent future leaking of blood from the affected artery.
* Endovascular treatment of aneurysms
In this procedure, a radiologist passes a catheter (thin tube) through the artery to the opening into an aneurysm. Detachable platinum coils are then deposited in the aneurysm to fill it up and prevent blood from entering, eliminating the possibility of hemorrhage.

AVM Treatment

* Surgical arteriovenous malformation removal
It is not always possible to remove an arteriovenous malformation (AVM) if it is too large or located deep within the brain. Surgical removal of a smaller AVM from a more accessible portion of the brain can eliminate the risk of AVM rupture.
* Stereotactic Radiosurgery
Stereotactic radiosurgery may be used to obliterate AVMs. This procedure focuses a beam of radiation on the AVM, causing it to clot and eventually disappear.
* Endovascular treatment (coil embolization) of AVMs
This procedure is similar to the treatment for aneurysms. A catheter is inserted into a leg artery and threaded through the body to the brain arteries. The catheter is positioned in one of the feeding arteries to the AVM, and coils, small particles or a gluelike substance is injected to block the vessel and reduce the blood flow into the AVM.

General Hemorrhage Treatments

* Removal of hematoma
Removal of a hematoma may be needed, especially when bleeding occurs in the back of the brain. Some physicians are investigating whether the injection of a clot busting drug inside the hematoma can help with the removal of brain hemorrhages through needles or catheters, therefore allowing less invasive surgery.
* Ventriculostomy
A procedure called ventriculostomy may be performed if fluid accumulates due to bleeding in the brain and needs to be drained

i have an AVM....

it sux!
i use to type well... not any more!
i use to type my friends and they could understand me... not any more!

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