Hemorrhagic Stroke

Our topic now moves into hemorrhagic stroke. Under hemorrhagic stroke, intracerebral hemorrhage. How did this occur? Was there hypertension, for example You’ve heard of berry aneurysm. Whenever you hear about aneurysm, what are you worried about? With an aneurysm, you’re worried about enough of expansion taking place where a rupture may take place, resulting in a type of hemorrhage. Well, no exception here. And say that your patient has hypertension and you have a berry aneurysm in the anterior portion of the circle of Willis. Maybe the anterior communicating artery. May result in intracerebral hemorrhage. Mass lesions. For example, metastatic lesions. You could have choriocarcinoma. Extremely common in terms of where it metastasizes. So for example, you find your patient to have beta hCG to be elevated, choriocarcinoma, gestational and non-gestational choriocarcinoma. Metastasis unfortunately could be up to the brain. Melanoma to the brain. Thyroid cancer to the brain. Lung to the brain. Renal carcinoma to the brain. This is a beautiful list of differentials. Cancer differentials that commonly, commonly, may have brain metastasis resulting in what? Hemorrhagic type of stroke. Vascular malformations Amyloid angiopathy. Usually, when you hear about amyloid especially up in the brain, you should be thinking about your Alzheimer’s and some of that amyloid, when it starts accumulating in your blood vessel, you call this amyloid angiopathy. At risk for what? Hemorrhagic stroke. Cocaine/amphetamine use. Some of these, you’ll find overlap with ischemic stroke as well. Remember it’s a little fine line, isn’t it? Between an ischemic stroke and then if the blood vessel in fact does rupture, may result in hemorrhagic stroke. It changes the complexion of the stroke clinically, but it could actually be part of a continuum. So keep that in mind. Don’t be so black and white that you think, “Oh, it...