Difference between a CT scan and an MRI Scan

Having a CT scan involves lying on your back, with your head positioned inside the scanner. It takes about five to ten minutes and is completely painless. The doctor may want a scan done after dye is injected into one of your veins, so the injection might be a bit painful. If you are allergic to iodine, make sure the doctor or radiographer knows – in most cases a scan using a dye is not essential.

An MRI scan also involves your lying on your back, and you go into an enclosed tunnel; the machine is quite noisy. (They may play you your favorite music while the scan is being done, to make it slightly more pleasant.) As with a CT scan, it takes only a few minutes, depending on how many bits have to be scanned. The MRI machine contains a very powerful magnet, so, if you have any metal bits inside you or a pacemaker, you probably won’t be able to have the scan. (It is also very good at wiping clean the magnetic strips on your credit cards!) The tunnel can cause problems for people who get claustrophobic but, because the MRI scan can provide information much more easily than the alternatives, if your doctor advises one, it might be best to grit your teeth and get on with it. If you really think it might be too much, ask if it is possible to have a short-acting sedative to help calm your nerves.

Recovery after Brain Hemorrhage

The damage caused by a stroke can be widespread and long-lasting. Many people need to have a long period of rehabilitation before they can recover their former independence.

The process of rehabilitation will be specific to you, and will depend on your symptoms and their severity. A team of specialists are available to help, including physiotherapists, psychologists, occupational therapists, speech therapists, and specialist nurses and doctors.

The damage that a stroke causes to your brain can impact on many aspects of your life and well-being, and depending on your individual circumstances, you may require a number of different treatment and rehabilitation methods

Psychological impact The two most common psychological conditions found in people after a stroke are:

• depression - many people find that they experience intense bouts of crying, and feel hopeless and withdrawn from social activities, and
• anxiety disorder - many people experience general feelings of fear and anxiety, often punctuated by intense, uncontrolled feelings of anxiety (anxiety attack).

Brain Hemmorhage - Stroke Treatment

TreatmentIschaemic strokes Ischaemic strokes can be treated using a medicine called alteplase, which dissolves blood clots. However, alteplase is only effective if used during the first three hours after a stroke has taken place. After that time the medicine has no beneficial effects.

You will also be given a regular dose of aspirin as this makes the cells in your blood, known as platelets, less sticky, reducing the chances of further blood clots occurring. If you are allergic to aspirin, other anti-platelet medicines are available.

AnticoagulantsYou may also be given an additional medication called an anticoagulant. Like aspirin, anticoagulants also prevent blood clots by changing the chemical composition of the blood in a way that prevents clots from occurring. Heparin and warfarin are two anticoagulants that are commonly used.

Anticoagulants are often prescribed for people who have an irregular heartbeat that can cause blood clots.

Blood pressureIf your blood pressure is too high, you may be given medicines to lower it. Two medicines that are commonly used are:

thiazide diuretic - which reduces the amount of water in your body and widens the blood vessels, which decreases blood pressure, andangiotensin converting enzyme (ACE) inhibitors, which widen the blood vessels and reduce blood pressure.StatinsIf the level of cholesterol in your blood is too high, you will be given a medicine known as a statin. Statins reduce the level of cholesterol in your blood by blocking an enzyme (chemical) in the liver that produces cholesterol.

Carotid stenosisSome ischaemic strokes are caused by a blockage in the carotid artery, which is an artery in the neck. The blockage, known as carotid stenosis, is caused by a build-up of fatty plaques.

If the carotid stenosis is particularly bad, surgery may be used to unblock the artery. This can be done using a surgical technique called a carotid endarterectomy, which involves the surgeon making an incision in your neck in order to open up the carotid artery, and remove the fatty deposits.

Haemorrhagic strokesEmergency surgery is often required to treat haemorrhagic strokes in order to remove any blood from the brain, and repair any burst blood vessels. This is usually done using a surgical procedure known as a craniotomy.

During a craniotomy, a small section of your skull is cut away to allow the surgeon to gain access to the cause of the bleeding. The surgeon will repair any damaged blood vessels, and will ensure that there are no blood clots present that may restrict the blood flow to your brain. After the bleeding has been stopped, the piece of bone removed from the skull is replaced.

Following a craniotomy, you may have to be placed on a ventilator. A ventilator is a machine that assists you with breathing. It gives your body time to recover by taking over its normal responsibilities, such as breathing, and it will also help control any swelling that you have in your brain.

You will also be given medicines, such as ACE inhibitors, to lower your blood pressure and prevent further strokes from occurring.

Transient ischaemic attack (TIA)The treatment for a transient ischaemic attack involves addressing the conditions that led to it, while trying to prevent those conditions causing a bigger, more serious stroke.

If you have a TIA, the treatment that you receive will depend on what caused it, but typically, you will be given one of the medicines outlined above, or a combination of them. So, if high blood pressure, and high cholesterol levels put you at risk of having a stroke, you may be given a combination of statins and ACE inhibitors.

If the risk of a stroke is very high, due to a build-up of fatty plaques in your carotid artery, a carotid endarterectomy may be required.

Symptoms of Brain Hemorrhage

The symptoms of a stroke depend on what part of the brain and how much of the brain tissue is affected.

Stroke symptoms usually come on suddenly—in minutes to an hour.

There is usually no pain associated with the symptoms.

The symptoms may come and go, go away totally, or get worse over the course of several hours.
If the symptoms go away completely in a short time (fewer than 24 hours), the episode is called a transient ischemic attack (TIA).

A third of all strokes occur during sleep, so people first notice the symptoms when they wake up.
These are the common symptoms of stroke:

• Weakness in the arm or leg or both on the same side: This can range from total paralysis to a very mild weakness. Complete numbness or a pins-and-needles feeling may be present on one side of your body or part of one side of your body.


• Weakness in the muscles of the face: Your face may droop or look lopsided. Speech may be slurred because you can't control the movement of your lips or tongue.


• Difficulty speaking: You can't speak, speech may be very slurred, or when you speak, the words sound fine but do not make sense.


• Coordination problems: You may seem uncoordinated and stumble or have difficulty walking or difficulty picking up objects.


• Dizziness: You may feel drunk or dizzy or have difficulty swallowing.


• Vision problems: You may develop difficulty with vision, such as double vision, loss of peripheral (side) vision, or blindness. (Blurred vision by itself is not usually a symptom of stroke.)


• Sudden headache: A sudden, severe headache may strike like "a bolt out of the blue." Some people have called this the worst headache of their lives.


• Loss of consciousness: You may become unconscious, stuporous, or hard to arouse and could die.

Causes of Stroke - Brain Hemorrhage

Stroke Causes
Of the 2 main types of stroke, the ischemic stroke occurs 80-85% of the time. With an ischemic stroke, a blood vessel in the brain becomes clogged. With a hemorrhagic stroke, a blood vessel in the brain actually bursts or leaks.

Hemorrhagic strokes tend to be more serious. The distinction between type of stroke can be critical in determining the treatment used.

Ischemic strokes occur when a blood vessel gets so narrow or clogged that not enough blood can get through to keep the brain cells alive.

Plaques (or build-up of cholesterol-containing fatty deposits called arteriosclerosis) in the blood vessel walls can narrow the blood vessels that supply the brain. These plaques build up until the center of the blood vessel is so narrow that little, if any, blood can get past. Many things including high cholesterol and high blood pressure cause plaques. The plaques may occur in small vessels that supply only a very tiny portion of the brain but may also occur in the big blood vessels in the neck (carotids) or in the large arteries to the brain (cerebral arteries).

Ischemic strokes may also be caused by small blood clots or emboli that go through the bloodstream and then get clogged in an artery when the artery narrows. These clots can come from pieces of plaques in the bigger arteries that break off or from the heart.

Hemorrhagic strokes occur when the wall of a blood vessel becomes weak and blood leaks out into the brain.

In addition to having decreased blood flow past the leak, the blood in the brain damages brain cells as it decomposes. If a lot of blood leaks out, it can cause a build-up of pressure in the brain because the brain is enclosed in the skull. There is not room for it to expand, and it can compress and kill important areas of the brain.

Hemorrhagic strokes tend to be more serious than ischemic strokes. Death occurs in 30-50% of people with this type of stroke.

Brain Hemorrhage - Stroke Overview

Stroke is a brain attack. It is much like a heart attack, only it occurs in the brain. Like a heart attack, stroke is a medical emergency. Do not wait or hesitate to call for emergency medical help. Fast treatment makes a big difference in outcome for someone having a stroke.

When the blood supply to a part of the brain is cut off or greatly decreased, a stroke occurs. If the blood supply is cut off for several hours or more, the brain cells, without enough blood supply, die.

Depending upon the amount of blood involved and location of the stroke area in the brain, a person having a stroke can show many signs and symptoms. These can range from barely noticeable difficulties moving or speaking to paralysis or death.

Until recently, doctors were unable to do much while a person was having a stroke or immediately afterward. Now however, treatments for the acute event, while it is happening, are available, which makes recognizing strokes and getting immediate care critically important.

About 750,000 new strokes occur in the United States each year. Stroke is the third most common cause of death (after heart disease and cancer). Strokes occur more frequently in older people but can occur in persons of all ages, including children. African Americans are at a higher risk of stroke than whites. Hispanics have an intermediate risk.

A transient ischemic attack (known as a TIA or ministroke) is similar to a stroke except that, with a TIA, the symptoms go away completely within 24 hours. People who have a TIA are very likely to have a stroke in the near future.

What is a stroke?

The brain is split into two halves, the left and the right hemispheres. At the base of the brain is the cerebellum and leading from the brain down into the spinal cord is the brainstem. All the information that is detected by the nerve endings in the body is passed up the spinal cord and brainstem to one of the cerebral hemispheres. There the brain decides what it needs to do and sends the relevant instructions back down the same route to activate the muscles. For example, if you touch something very hot, your brain receives the message and tells your hand to move away.

The left hemisphere largely controls the right-hand side of the body, and the right hemisphere the left side. The brain has specific parts devoted to specific functions. For example, the language areas are usually in the left-hand side of the brain, except in a small proportion of left-handed people in whom the language area is on the right. The areas processing information about vision are at the back of the brain. Control of muscle and sensory function is situated near the front of the brain in the frontal and parietal lobes, and co-ordination is controlled by the cerebellum.

The blood to the brain travels from the heart through the aorta (the main artery from the heart) and then into one of four arteries that lead to the brain. At the front are the two carotid arteries that you can feel pulsating in your neck, either side of the windpipe, and at the back, running alongside the vertebral column (the spine), are the two vertebral arteries. Once the four arteries have entered the skull, they are linked together in the circle of Willis this is a very important anatomical feature, because, if one artery is blocked, sometimes there is enough blood provided from the other arteries joining the circle to prevent major damage being done. Leading off the circle of Willis are the six major cerebral arteries – anterior, middle and posterior (one of each on either side), supplying respectively the front, middle and back parts of the brain. Any of these can be blocked, causing a stroke, but the commonest to be affected is the middle cerebral artery.