The key difference between brain hemorrhage and stroke is that the strokes are either due to an arterial occlusion or due to the rupturing of an artery. A brain hemorrhage occurs following such an arterial rupture. Thus, brain hemorrhage is actually a cause of stroke.
Strokes are one most of the commonest causes of deaths in the developed countries. They are also on the rise as a major cause of morbidity in the developing countries. They are a syndrome of rapid onset of cerebral deficit which lasts for more than 24 hours or leads to death with no cause apparent other than a vascular one.
CONTENTS
1. Overview and Key Difference
2. What is a Brain Hemorrhage
3. What is a Stroke
4. Relationship Between Brain Hemorrhage and Stroke
5. Side by Side Comparison – Brain Hemorrhage vs Stroke in Tabular Form
6. Summary
What is a Brain Hemorrhage?
As the name implies, a brain hemorrhage is a hemorrhage within the brain tissue. This mostly happens due to a rupturing of a blood vessel due to hypertension.
Figure 01: Brain Hemorrhage
A damaged artery is unable to supply blood sufficiently. Thus, there are functional impairments in the area that is supplied with blood by this particular. It is these above-mentioned functional impairments that are identified as a hemorrhagic stroke.
What is a Stroke?
Stroke is a syndrome of rapid onset of cerebral deficit which lasts for more than 24 hours or leads to death with no cause apparent other than a vascular one. In a stroke, the blood supply to the brain is compromised. Furthermore, depending on the way this happens, there are two subcategories of strokes as ischemic and hemorrhagic strokes.
Ischemic Strokes
Aan ischemic stroke is the impairment of the blood supply to the brain, secondary to an obstruction in a cerebral vessel. In fact, a vast majority of the strokes are ischemic strokes.
Causes
Atrial fibrillation and arrhythmias leading to the formation of thrombi and their subsequent embolization is the commonest cause of strokes. Simultaneous infarcts in different vascular territories are a clear indication of a cardiac embolic stroke.
- Hypoperfusion
- Large artery stenosis
- Small vessel disease
Figure 02: Ischemic Stroke
Clinical Features
- Loss of motor control and sensation over different regions of the body, which depends on the affected brain area
- Visual changes and deficits
- Dysarthria
- Loss of consciousness
- Facial droop
Hemorrhagic Strokes
It is damage to a vessel or vessels impairs the blood supply to the brain in a hemorrhagic stroke. Blood vessels with aneurysms and weak walls are more susceptible to get ruptured and give rise to hemorrhages inside the cranial cavity.
Causes
- Subarachnoid hemorrhages
- Intracerebral hemorrhages
The causes for these hemorrhages may include trauma, arteriovenous malformations, rupturing of aneurysms, etc.
Clinical Features
The clinical features will be similar to those of ischemic hemorrhages. Moreover, subarachnoid hemorrhage can also give rise to the following set of signs and symptoms.
- Sudden onset of a severe headache
- Vomiting
- Nausea
- Syncope
- Photophobia
Risk Factors
- Hypertension
- Chronic smoking
- Sedentary and stressful lifestyle
- Sleep apnea
- Carotid stenosis
- Chronic alcoholism
- High cholesterol
- Atrial fibrillation
- Obesity
- Diabetes
Management
- Amit the patient immediately to a multidisciplinary care unit.
- Take the following general measures.
- Confirm the patency of the airway and continue monitoring it to identify any obstructions in it
- Monitor the blood pressure while providing oxygen via a mask
- Try to identify the source of emboli
- Assess the ability of the patient to swallow
Brain imaging is necessary for the assessment of the degree of damage and the probable cause. CT and MRI are the most appropriate imaging modalities. If the radiographs show the presence of hemorrhage, avoid giving any drug that can interfere with clotting. But, if there is no hemorrhage and thrombolysis is not contraindicated, start the thrombolytic therapy immediately.
In case of hemorrhages, neurosurgeries are occasionally required to drain the blood that has accumulated inside the cranial cavity and prevent the buildup of an undue pressure that can compress the brain substances.
In the long term management of stroke patients, it is important to identify the above risk factors and take measures to minimize the risk on patient’s life. Antihypertensive therapy and anticoagulant therapy (especially in patients with atrial fibrillation) are two important aspects of the long-term management of stroke patients. Psychotherapy and physiotherapy are also helpful in improving the patient’s quality of life.
What is the Relationship Between Brain Hemorrhage and Stroke?
- Brain hemorrhage itself is a cause of stroke.
What is the Difference Between Brain Hemorrhage and Stroke?
A brain hemorrhage is a hemorrhage within the brain tissue. Stroke, on the other hand, is a syndrome of rapid onset of cerebral deficit which lasts for more than 24 hours, or leads to death with no cause apparent other than a vascular one. Brain hemorrhage is due to the rupturing of a blood vessel within the brain tissues that causes extravasation of blood. In contrast, stroke is due to the ischemia of brain tissue following the occlusion of an artery or an arterial rupture.
Summary – Brain Hemorrhage vs Stroke
Brain hemorrhage is a cause of stroke, which simply is an extravasation of blood within the brain matter due to an arterial rupture. Overall, this is the basic difference between brain hemorrhage and stroke.
Reference:
1. Kumar, Parveen J., and Michael L. Clark. Kumar & Clark clinical medicine. Edinburgh: W.B. Saunders, 2009.
Image Courtesy:
1. “Stroke ischemic” By National Heart Lung and Blood Insitute (NIH) – National Heart Lung and Blood Insitute (NIH) (Public Domain) via Commons Wikimedia
2. “3168269” (CC0) via Pixabay