Hemorrhagic stroke

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Urinary catheterization or bladder or bowel control programs may be required to control incontinence.

A safe environment must be considered. Some people with stroke appear to have no awareness of their surroundings on the affected side. Others show a marked indifference or lack of judgment, which increases the need for safety precautions.

In-home care, boarding homes, adult day care, or convalescent homes may be required to provide a safe environment, control aggressive or agitated behavior, and meet physiologic needs.

Behavior modification may be helpful for some patients in controlling unacceptable or dangerous behaviors. This consists of rewarding appropriate or positive behaviors and ignoring inappropriate behaviors (within the bounds of safety). Reality orientation, with repeated reinforcement of environmental and other cues, may help reduce disorientation.

Family counseling may help in coping with the changes required for home care. Visiting nurses or aides, volunteer services, homemakers, adult protective services, and other community resources may be helpful.

Legal advice may also be appropriate early in the course of the disorder. Advance directives, power of attorney, and other legal actions may make it easier to make ethical decisions regarding the care of the person with hemorrhagic stroke.

Stroke is the third leading cause of death in developed countries. About one-forth of people who have a stroke die as a result of the stroke or its complications, about one-half have long-term disabilities, and about one-forth recover most or all function.

Hemorrhagic stroke is less common but more frequently fatal than ischemic stroke.

• Pressure sores
• Permanent loss of movement or sensation of a part of the body
• Joint contractures
• Muscle spasticity
• Permanent loss of cognitive or other brain functions (dementia)
• Disruption of communication, decreased social interaction
• Decreased ability to function or care for self
• Decreased life span
• Urinary and respiratory tract infections