Understanding ischaemic and hemorrhagic strokes: Causes, symptoms, and treatments to maintain brain health

Hemorrhagic strokes are caused by blood artery ruptures that cause internal bleeding in the brain. (Image: Canva)

Strokes, which impact millions of people annually, are a serious global health concern. Comprehending the different categories of strokes is imperative for effective prevention, management, and recovery. Hemorrhagic and ischaemic strokes are the two main forms, each with its own causes, risk factors, and treatment methods.

Causes

Ischaemic stroke

When a blood clot obstructs or narrows an artery supplying the brain, an ischaemic stroke happens, says Dr Vipul Gupta, group director of neurointervention at Paras Hospital, Gurugram. These clots often develop in regions where fatty deposits have narrowed the arteries, a condition called atherosclerosis. The two primary forms of ischaemic strokes are thrombotic strokes, caused by a clot forming at the site of the blocked artery, and embolic strokes, caused by a clot moving from another part of the body to the brain.

Hemorrhagic stroke

When a blood vessel in the brain ruptures, causing bleeding inside or around the brain, a hemorrhagic stroke occurs. Causes include high blood pressure (hypertension), arteriovenous malformations (AVMs), and aneurysms, according to Dr Gupta. Hemorrhagic strokes are classified into two categories: subarachnoid haemorrhage, which occurs in the area between the brain and the surrounding membrane, and intracerebral haemorrhage, which happens inside the brain.

Symptoms

Ischaemic stroke symptoms

An ischaemic stroke can cause sudden weakness or numbness in the face, arm, or leg, especially on one side of the body. Other symptoms include disorientation, difficulty speaking or understanding others, vision problems, difficulty walking, dizziness, or loss of balance and coordination.

Hemorrhagic stroke symptoms

Symptoms of hemorrhagic stroke can be similar to those of ischaemic stroke but may also include loss of consciousness, severe headache, nausea, vomiting, and seizures. These symptoms result from the additional pressure the bleeding exerts on the brain.

Also see | Boost brain health: 8 essential strategies to implement in your 20s, 30s, and 40s

Treatment

Ischaemic stroke treatment

Restoring blood flow to the brain is the main objective of treatment for an ischaemic stroke. Dr Gupta notes that clot-busting medications (thrombolytics), such as tissue plasminogen activator (tPA), can achieve this if administered within a few hours of symptom onset. In some cases, a mechanical thrombectomy, which involves physically removing the clot, may also be performed.

Hemorrhagic stroke treatment

The goals of treatment for hemorrhagic stroke are to reduce cerebral pressure and stop the bleeding. This may involve surgery to repair blood vessels or relieve pressure, medications to control blood pressure and prevent seizures, and close monitoring in a critical care environment.