Intracerebral Hemorrhage

2021-05-12 17:59:32
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Intracerebral hemorrhage is an indicator of high manifestation of the progressive cerebral capillary disease. The manifestation of such an anomaly in the brain can be key indicators of risk to the development of diseases such as stroke. Stroke occurs as a result of a sudden interruption of blood flow to a specific region of the brain causing such effects as slurred speech, paralysis, blurred vision and numbness. The process leading to the thickening of arteries that eventually leads to the occurrence of stroke and the consequential catastrophic damage to the cells is quite complex (Biffi et al., 2015).

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Stroke may arise, as a result of the thickening of large cerebral arteries such as carotid or small cerebral arteries such as medullary arteries. Most investigations on stroke have been centered on the major arteries, though there are chances, however slim, that it may also occur in the cerebral circulation. Evidence exists that suggest that the pathogenic processes that take place in the larger arteries might differ from those affect smaller arteries.

Atherogenesis is a term used to describe the process in which the tubes of blood vessels become constricted as a result of cellular and extracellular substances to the extent that they become obstructed. This occurs in phases. Based on the autopsy of arteries and aortas of 1,160 individuals who died between birth and the age of 29, the earliest lesions of arteriosclerosis (thickening of the arteries) manifest as a fatty streak (O'Neill, 2012). A microscopic examination of these lesions reveals that they are lipid-filled foam cells. The autopsy further revealed that approximately eight percent of children in late childhood or just entering into adolescence had advanced beyond the fatty streaks and had developed more advanced lesions located at the points where the arteries branch off. These advanced lesions are filled with much more extra cellular lipids that dislodge normal cells. As we age, the lesions grow into the more complicated fibrous matter, comprising of a centrally located area of acellular lipids that is covered by strong muscles.

Literature review

There is a strong relationship between blood pressure and Intracerebral hemorrhage (ICH). This is based on a study conducted on ICH survivors or their caregivers who were interviewed regularly after 3, 6, 9 and 12 months after ICH and six months after that, based on established protocols. Event rates for the development of ICH were computed during the study period and the recurrence per 1000 person-years. The approach used involved patients contributing time at risk to the adequate vs. inadequate BP control groups all within the six months follow-up period. All this was based on the corresponding BP measurements (Summers et al., 2009).

The determination of the relationship between BP and ICH recurrence tests according to the study was achived though Cox regression analysis with BP variables as time-varying covariates. Hopeful covariates incorporated all variables with P < .20 for affiliation with repetitive ICH in bi-variable investigation and components possibly connected with intermittent ICH in view of former studies (past symptomatic discharge before file ICH, training level, race /ethnicity)

The subjects for test were responsive and cooperative in the provision of sufficient data for the experiment. The investigators collected records on ICH recurrence, death and medication use and dosage. From a single-center cohort observational study a relationship between the BP and the recurrent risk of ICH showed a stronger but with a worsening harshness of the hypertension. Of importance according to the study was the identification of recurrence of ICH and that one of the BP showing an increase in the antihypertensive therapy for the old patients.Risk Factors, Prevalence, Incidences, and Disparities

Anyone is vulnerable to stroke attack at any age. Chances of having a stroke attack increase if you are exposed to certain risk factors. The best way one can avoid stroke is to have an understanding of these risk factors and how to manage them. Some risk factors cannot be avoided, such as your age and your family history. Some can, however, be avoided such as those that are lifestyle related (Abbott, 2009).

Age is the most dominant stroke risk factor. For each successive ten years after you clock fifty-five years, chances of having stroke doubles for both genders. Men are 1.25 times more likely to suffer from stroke as compared to women (Summers et al., 2009). However, more women die of stroke than men since women generally live longer than men. Stroke has mild to serious effects on both genders, women tend to have a higher chance of healing and showing positive changes as compared to men mainly because of their resilience and strength to live on.

Family history might also be a stroke risk factor. The reasons for this could be a genetic predisposition to stroke or familial exposure to lifestyle or environmental risks. The mere fact that you are from a certain family is in itself a stroke risk factor. Stroke cases have been known to have been passes genetically through generations of a given family. It is the change of lifestyle habits and adoption of healthier practices can one escape from such a predicament.

Stroke incidences between the races have wide variances. Blacks are more than twice likely to suffer from stroke relative to their white counterparts. This could be explained by the fact that blacks have a higher predisposition to high blood pressure and obesity.

Hypertension implies that the blood is exerting harmful pressure on the blood vessels. With time this may cause damage to the walls of the blood vessels, leading to stroke, notably cerebral hemorrhage. Hypertension could also lead to constriction of blood vessels as a result of arteriosclerosis. The increased blood pressure could remove junks of debris from the arterial walls, which might end up blocking blood vessels leading to stroke.

Arteriosclerosis is a terms used to refer to inflammation of the artery. Normal arteries are flexible, and their walls are smooth. Arteriosclerosis, however, causes arteries to become stiff and constricted as a result of a deposition of debris on their walls. Arteriosclerosis can weaken the walls of small arteries which might lead to hemorrhage (Abbott, 2009).

Smoking more than doubles the risk of one getting stroke. This is because some of the chemical elements in smoke such as nicotine speed up arteriosclerosis. Also, smoking thickens the blood and may increase the chances of clotting as it makes platelets become sticky.

Some studies have shown that moderate alcohol intake can actually reduce chances of stroke. On the flip side, however, excessive alcohol consumption makes one three times more susceptible to stroke attack, especially brain hemorrhage (O'Neill, 2012).

A sedentary lifestyle, characterized by too much sitting, increases the likelihood of one getting hypertension, diabetes, and obesity, all of which are risk factors for stroke.

In the year 2008, stroke was the fourth leading cause of death as it was among the leading causes of severe long-term disability. Approximately half of the older survivors of stroke were faced with moderate to severe disability. The associated cost of caring for stroke survivors amounted to $18.8 billion in the US. Ascertaining stroke prevalence helps the responsible authorities to allocate resources to control the menace.

Incidences of stroke reduced from 1978 to 2011, based on a multicenter cohort of black and white communities across the US. This shows that efforts at curbing stroke were bearing fruits.

Racial disparities in stroke incidences are more prominent on the south eastern regions of the US. Blacks in these regions have higher reported incidences of stroke as well as stroke mortality, as compared to whites ("How OTs and PTs can help stroke patients recover", 2006).

Stroke Prevention

Much as you cannot reverse your race or your family lineage, there is an array of other ways to prevent stroke. This is done majorly by checking on the risk factors. Here are some of the ways of preventing stroke:

Lower your blood pressure by exercising, quit smoking for those who smoke, avoiding high cholesterol foods such as cheese, and reduce the amount of salt in your diet.

Losing weight: obesity makes one susceptible to stroke. It is important to keep your BMI at normal levels by increasing the amount of exercises and limiting or reducing saturated fat consumption.

Exercise: much as exercising eliminates stroke predisposing factors, it also on its own reduces chances o a stroke attack. A study on 212 women who had a walk 3 hours a week were less likely to have stroke compared to women who did not. One can simply use the stairs instead of the elevator or start a fitness club with friends (O'Neill, 2012).

Moderate on your drinking. Red wine should be a priority as it contains resveratrol which protects the heart as well as the brain (Abbott, 2009).

Taking all the above prevention mechanisms, it is upon the prerogative of an individual to take care of their health. Statistics indicate that 4 out of 10 people are likely to suffer from ICH. Change of lifestyles and adoption of healthier eating habits and exercising will help cut down the number of people contracting lifestyle diseases.

References

Abbott, A. (2009). Medical (Nonsurgical) Intervention Alone Is Now Best for Prevention of Stroke Associated With Asymptomatic Severe Carotid Stenosis: Results of a Systematic Review and Analysis. Stroke, 40(10), e573-e583. http://dx.doi.org/10.1161/strokeaha.109.556068

How OTs and PTs can help stroke patients recover. (2006). Nursing, 36(PT Insider), 17. http://dx.doi.org/10.1097/00152193-200610002-00005

O'Neill, D. (2012). Ageing and caring. Dublin: Orpen.

Summers, D., Leonard, A., Wentworth, D., Saver, J., Simpson, J., & Spilker, J. et al. (2009). Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient: A Scientific Statement From the American Heart Association. Stroke, 40(8), 2911-2944. http://dx.doi.org/10.1161/strokeaha.109.192362Biffi, A., Anderson, C., Battey, T., Ayres, A., Greenberg, S., Viswanathan, A., & Rosand, J. (2015). Association Between Blood Pressure Control and Risk of Recurrent Intracerebral Hemorrhage. JAMA, 314(9), 904. http://dx.doi.org/10.1001/jama.2015.10082

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