stroke/brain bleed

[marie2014]

Is a hemorrhagic stroke the same thing as a brain bleed? I only ask because I never hear doctors say a pt just had a hemorrhagic stroke, I only hear them say that a patient has a bleed. Aren't they synonymous?

[0.adamantite]

I'm not sure but what about a subdural hematoma? Is that considered a brain bleed?

[calivianya, BSN, RN]

I tend to see the term "hemorrhagic stroke" used when there was no trauma - i.e. when the patient's bleed came from a hypertensive crisis or some other underlying problem.

I see the term "bleed" used more when the patient hit his/her head, got shot, etc. Either way, there is blood in the brain.

This is funny because I got hung up on the word "stroke" myself this weekend - had a guy who they said had a watershed stroke due to hypovolemia from sepsis. I wanted to argue if it's not clot or a bleed it's an anoxic brain injury, not a stroke, but people will call it whatever they want to. I think all of the above words get the point across that there is brain damage, which is the important part.

[Whispera, MSN, RN]

Here's the way I understand it:

A stroke is an artery blockage in the brain, and the tissue on the distal side of the blockage dies unless there's an intervention quickly to break up the blockage.

A hematoma is where there is a weakness in a blood vessel wall that balloons when there's the pressure of blood continuously pumping against it. Sometimes when there's a stroke a hematoma forms on the proximal side of the blockage.

A hemorrhage is when the blood vessel bursts. Hematomas are stretched blood vessels and have a great likelihood to burst. so they become hemorrhages. A hemorrhage is a bleed, brain or otherwise. Anytime there's bleeding in the brain, for whatever reason, it's called a "bleed."

[Loo17]

Where I work, the docs use "bleed" to describe blood in the brain after a fall or ruptured aneurysm most frequently.

[tlynnette418]

There are two different types of strokes- ischemic and hemorrhagic. Ischemic is more common and occurs with a clot or disruption in blood flow to the brain, such as afib. Hemorrhagic occurs with a vessel rupture causing a bleed in the brain. This can be caused by HTN or a trauma-related incident. You can have a pt with a bleed from a MVA and it's technically a stroke. We still do stroke education on these pts too. Subdural hematomas are not considered strokes bc it occurs outside the brain. Hope this helps.