A stroke involves a disruption in the blood vessels that supply blood to a region in the brain which results to brain damage. It can either be an occlusion of the vessel lumen or rupture of the supplying vessel. The main risk factor for the development of a hemorrhagic stroke is hypertension or increased blood pressure. If an individual is suspected of having one, there are various symptoms that you should be familiar with.
What are the usual symptoms?
A hemorrhagic stroke has an abrupt onset with high blood pressure, vomiting and neurologic deficits that worsens rapidly. These are the distinct characteristics but some individuals do not have these symptoms and the presentation appears similar to an ischemic stroke.
Motor deficits
The individual might experience issues with motor function due to a hemorrhagic stroke. Spasticity, weakness and paralysis can also occur in which the deficits become worse in various limbs depending on the stroke vessel distribution.
Sensory deficits
Individuals also have sensory deficits such as tingling, altered sensation and numbness. Always bear in mind that the deficits become worse in the upper or lower limbs depending on the distribution of the affected vessel.
Mental status
An individual with hemorrhagic stroke has likelihood to end up with diminished level of consciousness and even seizures. Both would require the insertion of a breathing tube or intubation due to the potential for the body to lose the airway in both events. In such cases, this requires management in an intensive care unit.
Aphasia
Issues with communication or aphasia can also occur especially in cases in which the middle cerebral artery is involved. These include Wernicke’s aphasia which is inability to process communication and Broca’s aphasia which is normal understanding but there is inability to communicate back.
Lack of pupil reactivity
This occurs from bleeding that compresses on the 3rd cranial nerve. It has parasympathetic fibers that travel on the exterior of the nerve in which the compression affects the fibers first. Since they are responsible for the reactivity of the pupil to light, this reflex is lost before the pupil size is affected. A pupillary exam will not only help localize the location of the injury but also its progression.
Horner’s syndrome
This syndrome occurs from damage to the sympathetic nerves. The condition has clinical features such as sagging of the upper eyelid, reduced sweating on the same side of the face and shrinking of the pupil. This is common in cases where the medulla, cerebellum and thalamus are involved.
Ataxia
Ataxia is the initial outcome of a hemorrhage in the cerebellum. In most cases, the clumsiness affects the same side of the body as a lesion in the cerebellum.