Abstract
Haemorrhagic stroke is a severe stroke subtype with high rates of morbidity and mortality. Although this condition has been recognised for a long time, the progressing haemorrhagic stroke has not received adequate attention, and it accounts for an even worse clinical outcome than the nonprogressing types of haemorrhagic stroke. In this review article, we categorised the progressing haemorrhagic stroke into acute progressing haemorrhagic stroke, subacute haemorrhagic stroke, and chronic progressing haemorrhagic stroke. Haematoma expansion, intraventricular haemorrhage, perihaematomal oedema, and inflammation, can all cause an acute progression of haemorrhagic stroke. Specific ‘second peak’ of perihaematomal oedema after intracerebral haemorrhage and ‘tension haematoma’ are the primary causes of subacute progression. For the chronic progressing haemorrhagic stroke, the occult vascular malformations, trauma, or radiologic brain surgeries can all cause a slowly expanding encapsulated haematoma. The mechanisms to each type of progressing haemorrhagic stroke is different, and the management of these three subtypes differs according to their causes and mechanisms. Conservative treatments are primarily considered in the acute progressing haemorrhagic stroke, whereas surgery is considered in the remaining two types.
Highlights
Haemorrhagic stroke, which accounts for 10–20 % of all of the new strokes that occur every year [78], has a 1-month mortality rate of approximately 40 % [164]
As with progressing ischemic stroke, a deterioration of clinical signs and symptoms often happens within 24–72 h with intracerebral haemorrhage and is associated with haematoma expansion [30], perihaematomal oedema [46], intraventricular haemorrhage [100], and inflammation [155]
We proposed the concept of progressing haemorrhagic stroke and summarised the three categories of progressing haemorrhagic stroke, which are as follows: acute progressing haemorrhagic stroke, subacute progressing haemorrhagic stroke and chronic encapsulated intracerebral haematoma
Summary
Haemorrhagic stroke, which accounts for 10–20 % of all of the new strokes that occur every year [78], has a 1-month mortality rate of approximately 40 % [164]. Intraventricular haemorrhage, perihaematomal oedema, and inflammation, can all cause an acute progression of haemorrhagic stroke.
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