Difference Between an Ischemic and a Hemorrhagic Stroke

Edited by Diffzy | Updated on: October 06, 2022

       

Difference Between an Ischemic and a Hemorrhagic Stroke Difference Between an Ischemic and a Hemorrhagic Stroke

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Introduction

According to a poll, roughly 795,000 people in the United States have strokes each year, with 137,000 people dying as a result. Ischemic strokes are responsible for 87 percent of the cases. Early stroke symptoms include numbness in facial muscles or weakness on one side of the body, visionary unease and muddled judgments, dizziness, and loss of balance.

Experts say that A stroke happens when blood flow to a part of your brain is interrupted. Your brain cells will starve for oxygen if there's not enough blood, so they will eventually die. The type of injury caused by a stroke is governed by where it happens in the brain.

Early detection is crucial for surviving a stroke. This entails paying close attention to the most common signs and symptoms of a stroke (Ischemic vs Hemorrhagic Stroke: Causes, Symptoms, Treatment, and Prognosis, n.d.).

Hence, we shall compare and contrast the causes, symptoms, diagnosis, and management of ischemic and hemorrhagic strokes in this section.

Ischemic Stroke vs Hemorrhagic stroke

Ischemic stroke actually happens when the blood flow to the patient's brain is impeded by blood clots or thrombosis, while hemorrhagic stroke happens whenever a damaged blood vessel bursts and bleeds through into the brain, causing bleeding inside the patient's brain. Another distinction is that a hemorrhagic stroke patient frequently suffers excessively painful headaches, which can be a marker of hemorrhagic stroke beginning, whereas an ischemic stroke patient does not.

Difference Between Ischemic stroke and Hemorrhagic stroke in Tabular Form

Table: Ischemic Stroke vs Hemorrhagic stroke
Parameters of Comparison
Ischemic stroke
Hemorrhagic stroke
The cause
Whenever the blood supply to the brain is restricted because of excessive blood clotting or fatty plaque build-up in blood arteries, an ischemic stroke occurs.
It occurs when a blood vessel bursts, which leads to a flood of blood inside the cranium or intracranial crevices, which results in excruciating pain and death.
The types
Embolic strokes, Thrombotic strokes.
Subarachnoid hemorrhage, Intracerebral hemorrhage.
The symptoms
Facial numbness and weakness, skewed judgment, and even a loss of balance are all symptoms.
Severe headaches, nausea, vision abnormalities, hearing problems, and seizures.
Percentage of occurrence
Ischemic strokes happen in roughly 87 percent of all strokes.
These strokes account for 10-15% of all strokes.
Some treatment options
Angioplasty and stent implantation are favoured surgical techniques.
It is primarily treated with pharmaceuticals, which include blood pressure-lowering catalysts (Difference Between an Ischemic and a Hemorrhagic Stroke (With Table), n.d.).

What is Ischemic Stroke?

Ischemia, also known as ischemia, is a condition in which blood flow to any tissues, group of muscles, or organ of the body is restricted, resulting in a lack of oxygen for cell metabolism (to keep tissue alive). Ischemia is caused by issues with blood arteries, resulting in tissue injury or dysfunction (hypoxia and microvascular dysfunction). It can also refer to local hypoxia in a specific area of the body, which can occur as a result of restriction (for example vasoconstriction, thrombosis, or embolism).

Ischemia includes not only a lack of oxygen, as well as a lack of nutrients and an insufficient clearance of metabolic wastes. Ischemia can be partial (low perfusion) or complete (no blood flow). The insufficient transport of oxygenated blood to the organs must be addressed either by addressing the underlying cause or lowering the oxygen demand of the system that requires it. Patients with myocardial ischemia, for example, have reduced blood supply to the heart and are given drugs to diminish chronography and inotropy so that the new level in the blood delivery provided by the stenosed is adequate.

Experts believe Ischemia can manifest itself in a variety of ways, depending on where it occurs in the body and how much blood flow is disrupted. Pain, pallor, pulselessness, paresthesia, paralysis, and poikilothermia are some of the clinical symptoms of acute limb ischemia.

Ischemia can quickly proceed to tissue necrosis and gangrene if not treated right away. The loss of nerves feeding the extremity is signalled by paralysis, which is a late symptom of severe arterial ischemia. Nerve injury might cause a drop in the foot. Because nerves are very sensitive to hypoxia, limb paralysis or ischemic neuropathy may linger and become permanent after revascularization (Ischemia, n.d.).

Research states that Transient Ischemic Attack, which is also known as TIA, is a condition that happens before to an ischemic stroke. A TIA is also referred to as a'mini-stroke.' It features symptoms that are comparable to those of an ischemic stroke, however, they are less severe. Ischemic illnesses are divided into two categories: thrombotic and embolic strokes. The latter is simply a more severe variation of the former, in which the clot is movable and can obstruct any nearby channel.

A Thrombotic Stroke develops when thrombosis causes a blood artery to have a high blood flow pressure. This sort of stroke can be avoided by adopting current procedures like Angioplasty to unblock the clogged conduit.

When thrombosis causes a blood vessel to have a high blood flow pressure, a Thrombotic Stroke occurs. This type of stroke can be avoided by using current treatments to unblock the clogged conduit, such as Angioplasty (Difference Between an Ischemic and a Hemorrhagic Stroke (With Table), n.d.).

Signs and Symptoms

The following are signs that you may be having an embolic kind of an ischemic stroke:

  • Numbness
  • Weakness
  • Vomiting
  • Nausea
  • Dizziness
  • Confusion
  • Paralysis on one side of the body (Brennan, 2021)

The treatment

So basically, it is critical to begin treatment as soon as possible in order to keep the damaged organ alive. Anticoagulant injections, thrombolysis, embolectomy, surgical revascularization, or partial amputation are among the therapy possibilities. Anticoagulant medication is started to prevent the thrombus from growing larger. The usual agent of choice has been continuous IV unfractionated heparin.

Recently generated emboli can be treated with catheter-directed thrombolysis using an intra-arterial infusion of a thrombolytic drug (e.g., recombinant tissue plasminogen activator (tPA), streptokinase, or urokinase) if the ischemic limb's state is stabilized with anticoagulation. The medicine is infused using a percutaneous catheter placed into the femoral artery and threaded to the clot site. Thrombolytic medicines, unlike anticoagulants, work directly to dissolve the clot during a 24- to 48-hour period.

To remove the clot, a direct arteriotomy may be required. In the event of trauma, surgical revascularization may be done (e.g., laceration of the artery). When limb salvage isn't possible, amputation is the only option. If the patient is still at risk of embolization from a long-term source, such as chronic atrial fibrillation, long-term oral anticoagulation is used to avoid recurrent acute arterial ischemia events.

The aerobic metabolic rate of the afflicted cells decreases when body temperature drops, minimizing the acute effects of hypoxia. The inflammation response and reperfusion injury are both reduced when body temperature is lowered. Limiting thawing and reheating of tissues until warmer temperatures can be sustained may minimize reperfusion injury in frostbite patients.

In an attempt to reduce the incidence of adverse outcomes, ischemic stroke is sometimes treated with varying amounts of statin therapy at hospital discharge, followed by home time.

What is a Hemorrhagic Stroke?

Intracerebral hemorrhage (ICH), often referred to as the cerebral bleed, intraparenchymal bleed, hemorrhagic stroke, or hemorrhagic stroke, is sudden bleeding into the brain's tissues, ventricles, or both. It's a type of intracranial hemorrhage and a type of stroke. Headaches, one-sided weakness, vomiting, convulsions, a loss of consciousness, and neck stiffness are all possible symptoms. Symptoms frequently worsen over time. Fever is also another typical symptom.

Trauma to the brain, aneurysms, arteriovenous malformations, and brain cancers are all possible causes. High blood pressure and amyloidosis are the two biggest risk factors for spontaneous bleeding. Alcoholism, poor cholesterol, blood thinners, and cocaine use are all risk factors. The most common method of diagnosis is a CT scan. Ischemic stroke is another disorder that can present similarly (Intracerebral hemorrhage, n.d.).

In most cases, treatment should take place in an intensive care unit. Blood pressure should be reduced to a systolic of 140 mmHg, according to guidelines. If at all feasible, blood thinners should be stopped and blood sugar levels should be managed within normal limits. Hydrocephalus can be treated with surgery to insert a ventricular drain; however, corticosteroids should not be utilized. In some circumstances, blood removal surgery is beneficial.

Every year, roughly 2.5 persons per 10,000 are affected by cerebral hemorrhage. Males and the elderly are more likely to be affected. Within a month, about 44% of individuals infected die. About 20% of people who are affected have a positive outcome. Intracerebral hemorrhage, a kind of hemorrhagic stroke, was originally separated in 1823 from ischemic strokes caused by insufficient blood flow, referred to as "leaks and plugs."

The Symptoms and Signs

Intracerebral bleeding causes symptoms that correspond to the functions controlled by the brain area that has been injured by the hemorrhage. Other signs and symptoms include those that indicate an increase in intracranial pressure as a result of a big mass pressing against the brain.

Because of the similarities in symptoms and indications, intracerebral bleeds are sometimes misinterpreted as subarachnoid hemorrhages. One of the most common symptoms of intracerebral hemorrhage is a severe headache followed by vomiting. Another symptom is collapsing. Some people may experience ear bleeding on a regular basis. Before the bleed is recognized, some individuals may fall into a coma.

The Causes

Intracerebral bleeding is the second leading cause of stroke, accounting for 10% of all stroke hospitalizations. The risk of spontaneous intracerebral hemorrhage is increased by two to six times in people with high blood pressure. Intraparenchymal bleeding is more common in adults than in children and is mainly caused by penetrating head trauma, but it can also be caused by depressed skull fractures.

The risk factors include:

  • Hypertension (high blood pressure)
  • Diabetes mellitus
  • Menopause
  • Excessive alcohol consumption

The Treatment

The type of ICH has a big impact on the treatment. A quick CT scan and other diagnostic tools are utilized to decide the best course of action, which could include both medicine and surgery. When a person's level of consciousness is low or there's a chance of airway obstruction, tracheal intubation is recommended.

Isotonic rather than hypotonic IV fluids are provided to maintain fluid balance. A hemorrhagic stroke necessitates immediate medical attention. The goal of this treatment is to stop the bleeding in your brain and relieve the pressure generated by it.

Drugs can be used to lower blood pressure and slow bleeding. You're more likely to have severe bleeding if you have a hemorrhagic stroke while on blood thinners. During emergency treatment, drugs to counteract the effects of blood thinners are usually administered right away.

So basically, the length of recovery and rehabilitation is actually determined by the severity of the stroke as well as the extent of tissue damage. Depending on your needs, different methods of therapy may be used. Moreover, Physical treatment, occupational therapy, and speech therapy are all options. The main purpose of therapy is to help you regain as much function as you can.

Main Differences Between Ischemic Stroke and Hemorrhagic Stroke In Points

Now let’s study the major key differences between Ischemic stroke and Hemorrhagic stroke in brief:

  • Ischemic stroke occurs more frequently than hemorrhagic strokes.
  • Ischemic stroke is caused because of blood clotting, whereas hemorrhagic stroke is caused by the growth of hemorrhoids.
  • Embolic and thrombotic strokes are the two forms of ischemic strokes.
  • Intracerebral and subarachnoid strokes are both hemorrhagic strokes.
  • In the treatment of ischemic stroke, surgery is preferred.
  • For hemorrhagic strokes, drug-induced therapy is the first line of defense.
  • Furthermore, Patients who have had an ischemic stroke have a better chance of surviving than those who have had a hemorrhagic stroke

Conclusion

To conclude, it can be said that Strokes are extremely difficult to treat and have a high fatality rate due to the short time window for treatment. The most common types of strokes are ischemic and hemorrhagic strokes. The expense of treatment for both types is fairly high and requires a lot of resources.

References

  • Brennan, D. (2021, 01 3). What Is the Difference Between Ischemic Stroke and Hemorrhagic Stroke? Retrieved from MedicineNet: https://www.medicinenet.com/difference_ischemic_stroke_and_hemorrhagic_stroke/article.htm
  • Intracerebral hemorrhage. (n.d.). Retrieved from WIKIPEDIA: https://en.wikipedia.org/wiki/Intracerebral_hemorrhage
  • Ischemia. (n.d.). Retrieved from WIKIPEDIA: https://en.wikipedia.org/wiki/Ischemia
  • Ischemic vs Hemorrhagic Stroke: Causes, Symptoms, Treatment, and Prognosis. (n.d.). Retrieved from Bel Marra Health: https://www.belmarrahealth.com/ischemic-vs-hemorrhagic-stroke-causes-symptoms-treatment-prognosis/

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