Hemorrhagic stroke classification
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Hemorrhagic stroke Microchapters |
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Diagnosis |
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Treatment |
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AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage (2015) |
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AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012) |
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AHA/ASA Guideline Recommendation for the Primary Prevention of Stroke (2014) |
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AHA/ASA Guideline Recommendations for Prevention of Stroke in Women (2014) Sex-Specific Risk Factors
Risk Factors Commoner in Women |
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Case Studies |
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Hemorrhagic stroke classification On the Web |
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American Roentgen Ray Society Images of Hemorrhagic stroke classification |
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Risk calculators and risk factors for Hemorrhagic stroke classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Classification
Based on location of the hemorrhage, hemorrhagic stroke may be classified into:
Intracranial hemorrhage is the accumulation of blood anywhere within the skull vault. Intracranial hemorrhage are roughly grouped into:
- Intra-axial hemorrhage (blood inside the brain)
- Intraparenchymal hemorrhage, or bleeding within the brain tissue.
- Intraventricular hemorrhage, bleeding within the brain's ventricles (particularly of premature infants)
- Extra-axial hemorrhage (blood inside the skull but outside the brain)
- Epidural hemorrhage is caused by trauma, and results from laceration of an artery
- Subdural hemorrhage results from tearing of the bridging veins in the subdural space between the dura and arachnoid mater.
- Subarachnoid hemorrhage, like intraparenchymal hemorrhage, can result either from trauma or from ruptures of aneurysms or arteriovenous malformations
The main types of extra-axial hemorrhage are epidural hematoma (bleeding between the dura mater and the skull), subdural hematoma (in the subdural space) and subarachnoid hemorrhage (between the arachnoid mater and pia mater). Most of the hemorrhagic stroke syndromes have specific symptoms (e.g. headache, previous head injury).
Intracerebral hemorrhage (ICH) is bleeding directly into the brain tissue, forming a gradually enlarging hematoma (pooling of blood). It generally occurs in small arteries or arterioles and is commonly due to hypertension, trauma, bleeding disorders, amyloid angiopathy, illicit drug use (e.g. amphetamines or cocaine), and vascular malformations.
The hematoma enlarges until pressure from surrounding tissue limits its growth, or until it decompresses by emptying into the ventricular system, CSF or the pial surface.
A third of intracerebral bleed is into the brain's ventricles. ICH has a mortality rate of 44 percent after 30 days, higher than ischemic stroke or even the very deadly subarachnoid hemorrhage.