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Acute haemorrhagic stroke.

L I Worthley1, A W Holt

  • 1Department of Critical Care Medicine, Flinders Medical Centre, Adelaide, South Australia.

Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine
|April 8, 2006
PubMed
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Acute haemorrhagic stroke, often caused by hypertensive intracerebral haemorrhage or subarachnoid haemorrhage, requires prompt CT diagnosis. Management involves supportive care, clot evacuation for accessible bleeds, and specific treatments for subarachnoid haemorrhage, though resistant vasospasm remains challenging.

Area of Science:

  • Neurology
  • Neurosurgery
  • Emergency Medicine

Background:

  • Acute haemorrhagic stroke encompasses hypertensive intracerebral haemorrhage and subarachnoid haemorrhage (SAH).
  • Common symptoms include sudden severe headache and vomiting, with neurological deficits depending on lesion location.

Purpose of the Study:

  • To review the current management strategies for acute haemorrhagic stroke.
  • To highlight recent advancements in the treatment of haemorrhagic stroke.

Main Methods:

  • Literature review of articles and published reviews on acute haemorrhagic stroke.
  • Analysis of diagnostic and therapeutic approaches for intracerebral haemorrhage and SAH.

Main Results:

  • Diagnosis relies on urgent non-contrast cerebral computed tomography (CT) and, if necessary, lumbar puncture.

Related Experiment Videos

  • Treatment includes resuscitation, preventative therapies, and surgical clot evacuation for accessible intracerebral haemorrhage.
  • SAH management involves nimodipine and early surgery to prevent vasospasm and rebleeding; intravascular techniques show promise but resistant vasospasm is difficult to manage.

    • Conclusions:

    • Urgent CT scan is crucial for diagnosing acute haemorrhagic stroke.
    • Surgical intervention for intracerebral haematoma is indicated for accessible clots causing mass effect.
    • Standard SAH management includes nimodipine and early surgery, with ongoing challenges in managing resistant cerebral vasospasm despite new intravascular techniques.