To know the difference between Ischemic and Hemorrhagic Stroke, you must first know the clear concept of Stroke. Worldwide cerebrovascular accidents (Stroke) are a leading cause of death. In this article, we will describe the Stroke and the difference between ischemic and hemorrhagic Stroke.
What Is A Stroke?
A stroke occurs when the blood supply to part of the brain is suddenly interrupted or when a vessel in the brain bursts, spilling blood into the spaces surrounding brain cells.
Brain cells die when they no longer receive oxygen and nutrients from the blood or sudden bleeding into or around the brain.
The symptoms of a stroke include sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden walking: dizziness, loss of balance or coordination: sudden severe headache with no known cause.
What Is Ischemic Stroke & Hemorrhagic Stroke?
There are two main types of stroke: ischemic and hemorrhagic. An ischemic stroke occurs when a clot blocks a blood vessel that supplies blood to the brain. A hemorrhagic stroke occurs when a blood vessel in the brain ruptures and bleeds.
What Is Ischemic Stroke?
The most common type of Stroke, accounting for almost 80% of all strokes – is caused by a clot or other blockage within an artery leading to the brain. There are three subtypes:
Thrombosis: In situ obstruction of an artery.
Embolism: Particles of debris originating elsewhere that block arterial access to a particular brain region
Systemic Hypoperfusion: More general circulatory problem, manifesting itself in the brain and perhaps other organs.
What Is Hemorrhagic Stroke?
Due to intracerebral hemorrhage or subarachnoid hemorrhage. This is the cause of about 20% of all strokes. There are two types:
Intracerebral Hemorrhage(15%): Caused by bleeding within the brain and tissue.
Sub Arachnoid Hemorrhage(5%): Caused by extravasation into the subarachnoid space.
Causes Of Ischemic Stroke & Hemorrhagic Stroke
Ischemic Stroke is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Acute ischemic Stroke is caused by thrombotic or embolic occlusion of the cerebral artery and is more common than hemorrhagic Stroke.
Causes of Ischemic Stroke
Large Vessel Thrombotic or Virchow triad of thrombosis is known as Ischemic Stroke. A blockage causes ischemic Stroke in an artery supplying blood to the brain. The most common cause of this is a blood clot, which can be formed in the heart or elsewhere in the body.
Other causes include atherosclerosis (hardening of the arteries), Vasculitis (inflammation of the arteries), and other disorders that cause narrowing or blockage of the arteries.
- Blood vessel injury: HTN. Atherosclerosis. Vasculitis
- Stasis/ turbulent blood flow: Atherosclerosis. A. fib. Valve disorders
- Hypercoagulable state: Increased number of platelets, Deficiency of anti-coagulation factors, Presence of pro-coagulation factors, Cancer.
Large Vessel Embolic:
- The Heart: Valve diseases, A. Fib, Dilated cardiomyopathy, Myxoma
- Arterial Circulation (artery to artery emboli): Atherosclerosis of the carotid. Arterial dissection, Vasculitis
- The venous Circulation: PFO w/R to L shunt, Emboli
Causes of Hemorrhagic Stroke
Hemorrhagic Stroke is mainly caused by a ruptured blood vessel in the brain. There are many potential causes of hemorrhagic Stroke. One common cause is uncontrolled high blood pressure, which can cause weaken blood vessel walls and lead to bleeding.
Other causes include aneurysms (weak spots in blood vessel walls), AVMs (abnormal tangles of blood vessels), and cerebral amyloid angiopathy (a buildup of protein deposits in blood vessel walls).
Head trauma or injury can also lead to hemorrhagic Stroke, as can certain medications and medical conditions. Other causes of Hemorrhagic Stroke:
- Chronic HTN
- Cerebral Amyloid Angiopathy
- Anticoagulation
- AVM
- Ruptured aneurysm( usually subarachnoid)
- Tumor
- Sympathomimetics
- Infection
- Trauma
- Transformation of ischemic stroke
- Physical exertion, Pregnancy
- Post-operative
Signs and Symptoms of Ischemic Stroke Vs Hemorrhagic Stroke
Symptoms usually come on suddenly, within seconds or minutes:
Signs and Symptoms of Ischemic Stroke
Ischemic Stroke is a type of Stroke that occurs when the blood supply to the brain is interrupted. This can happen due to a blockage in the arteries that supply blood to the brain. Symptoms of ischemic Stroke include:
- You may also have a Transient Ischemic Attack (TIA) before a full-blown stroke excellent way to recognize if you or someone you’re with has had a stroke is to use the ‘FAST’ test.
- The exact symptoms depend on where the blood supply has been blocked in your brain. This is because different areas of your brain control different functions and receive blood through different arteries.
- A transient neurologic attack that lasts <24 hours (most last <1 hour) is determined to be of ischemic etiology.
- Anterior cerebral artery: Contralateral paresis and sensory loss in the leg. Cognitive or personality changes.
- Middle cerebral artery: Pneumonic: “changes” – Contralateral paresis and sensory loss in the face and the arm – Homonymous Hemianopsia – Aphasia – Neglect – Gaze preference toward the side of the lesion.
- Posterior cerebral artery: Pneumonic. The 4 D’s – Diplopia – Dizziness – Dysphagia – Dysarthria.
- Basal ganglia lacunar: pure motor or sensory Stroke, dysarthria-clumsy hand syndrome, ataxic hemiparesis.
- Basilar artery.
Signs and Symptoms of Hemorrhagic Stroke
There are several signs and symptoms of a hemorrhagic Stroke, and they can vary depending on the individual. Some common symptoms include:
- Severe headache from increased intracranial pressure.
- Progressive detenoration from continued bleeding.
- Vomiting from increased intracranial pressure.
- Neck stiffness from irritation.
- Bilateral Babinski signs from enlargement of hemorrhage beyond the blood vessel involved.
- Coma from bilateral cerebral dysfunction or un cal.
- Greater arm and leg hemiparesis.
If you experience any of these symptoms, it is important to seek medical attention immediately, as hemorrhagic Stroke can be fatal if not treated promptly.
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