What is the difference between a stroke and a cerebral hemorrhage?
A stroke is an acute circulatory disorder in the arterial vascular system of the brain. In about 80 to 85 % of cases, an ischemic event, i.e. reduced blood flow, is responsible for the stroke. The cause is usually the occlusion of an artery by a blood clot.
Atrial fibrillation is a frequently associated disease. In 15% of cases, however, a stroke can also be caused by intracerebral haemorrhage or subarachnoid haemorrhage. Strokes do not always show the same clear symptoms. One tries to classify them symptomatically roughly according to the affected area of the brain. A distinction is made between cerebral hemorrhages that occur after an accident.
Epidemiology – How often does it happen?
Spontaneous cerebral haemorrhages are the cause of a stroke in 15% of those affected. While men and women are affected about equally often, ethnic differences in frequency can be observed. In the white population, 15-20 new cases per 100,000 inhabitants are diagnosed each year, compared with 35 per 100,000 Hispanic and African-American inhabitants in the United States each year and even 60 new cases per 100,000 inhabitants among the Japanese each year. The likelihood of getting a brain hemorrhage increases with age.
Cause of a cerebral hemorrhage
There are several causes of spontaneous intracerebral hemorrhages. The most important risk factor for ICB (intracerebral bleeding) is high blood pressure (hypertension). An additional risk is associated with the use of certain medications, such as The anticoagulants heparin or Marcumar (anticoagulants), as well as therapies to prevent the formation or dissolution of blood clots, and to dissolve existing clots (thrombolysis), which are also used to treat a heart attack, or under therapy with aspirin, which prevents platelets from clumping together (platelet aggregation inhibitors) and is sometimes incorrectly called a blood thinner.
In addition to diseases of the haematopoietic system and coagulation disorders, risk factors include long-term alcohol or drug consumption, and possibly the use of certain medications, such as certain antibiotics or painkillers. Common risk factors for heart disease and vascular diseases such as diabetes mellitus, cigarette smoking and elevated blood lipid levels do not play a significant role in the development of intracerebral hemorrhage. The risk of bleeding can even be increased with lowered cholesterol values.
An aneurysm is a spindle- or bag-shaped dilatation of a cerebral artery. They occur mainly at branches of blood vessels and are more common in women than in men. Aneurysms are dangerous because they can burst and lead to cerebral haemorrhage.
Such a cerebral hemorrhage is called subarachnoid hemorrhage. These life-threatening hemorrhages are associated with a high mortality rate. Complications in the course of therapy are frequent and cause the poor prognosis.
Major risk factors for aneurysm bleeding are smoking, high alcohol consumption and untreated or untreated high blood pressure. However, some people also have wall weakness in their blood vessels, which is the preferred cause of aneurysms. Unfortunately, nothing can be done about this to date.
A cerebral hemorrhage can occur for a variety of reasons. A fall on the head is associated with a movement of the brain within the skull. This movement can cause the blood vessels in the brain to rupture, resulting in bleeding.
A cerebral hemorrhage as a result of a fall can generally happen to anyone. However, there are some risk factors that significantly increase the probability of a cerebral hemorrhage after a fall. Taking blood-thinning medication is a general risk of cerebral hemorrhage.
Patients who take blood-thinning medication are therefore at increased risk of developing a cerebral hemorrhage after a fall. A second risk group are alcoholized persons. Since the normally existing protective reflexes of alcoholized people are significantly reduced, the risk of falling on one’s head without braking is significantly increased.
In addition, the sense of balance is disturbed by alcohol and for this reason a fall is more likely.A blood-thinning therapy increases as an adverse effect, the risk of bleeding in general. Particularly feared are cerebral hemorrhages and severe gastrointestinal bleeding. Approximately 15% of spontaneous intracerebral hemorrhages are caused by blood-thinning therapy. Therefore, a blood-thinning therapy must always be carried out under consideration of the risks and the hoped-for benefits.
