Haemorrhagic stroke usually occurs in 3 different forms, each with a different cause:
Stroke: A ruptured blood vessel causes bleeding in the brain itself.
Subarachnoid haemorrhage: Blood penetrates the tissue after a rupture of a blood vessel between the meninges.
Bleeding as a result of accident: An accident such as a skull fracture causes a rupture (the most common cause of haemorrhagic stroke).
There are about 100,000 cases of stroke in UK each year, of which 1 out of 20 of these are a subarachnoid haemorrhage. The symptoms of a stroke are very similar to the symptoms of a blood clot in the brain, but are more often accompanied by headaches. The condition can affect consciousness and be extremely life threatening. The symptoms are usually acute and in the case of bleeding in the brain itself, the symptoms depend on the function of the area of the brain in question. With a subarachnoid haemorrhage, acute and extreme headaches - usually in the back of the head - are the most common symptom. In addition, symptoms such as decreased awareness and concentration, changes in mood and personality, and eye discomfort in response to light. It can result in paralysis, coma and death. Subarachnoid bleeding occurs more frequently in women than in men, although the cause is unknown.
Common risk factors are:
- Hypertension (high blood pressure)
- Aneurysm (rupture) of a blood vessel
- Blood-thinning treatment
- Malformed blood vessels
- Rare hereditary conditions
But perhaps smoking should be on this list?
Increased risk of haemorrhagic stroke in smokers – women are particularly vulnerable
Researchers from the University of Helsinki in Finland have conducted a study showing that smoking may increase the risk of subarachnoid haemorrhages for women. This assumption is based on data from 65,521 adults with an average age of 45 years, who participated in a national study in Finland from 1972 to 2013.
In the study, participants were followed from an average of 21 years, or until they had a stroke or died. During this period, participants responded to different questionnaires and participated in physical examinations.
The researchers compared non-smokers with smokers with regard to the number of cases of haemorrhagic stroke. The study showed that smokers experienced subarachnoid haemorrhages more often. The number of cigarettes per day was proportional to the risk of a haemorrhagic stroke. This relationship was most apparent in women, as the risk of bleeding in women was higher compared to men, even though smoking the same amount.
For light smokers, defined in the study as 1-10 cigarettes per day, the risk of having a haemorrhagic stroke was 1.96 times greater (about double) in men and 2.95 time greater (about triple) in women.
For moderate smokers, defined as 11-20 cigarettes a day, the risk was 2.13 times greater in men and 3.89 times greater in women.
Women who smoked between 21 and 30 cigarettes a day had 8.35 times greater risk than non-smokers to have a stroke, while the corresponding number of cigarettes a day in men increased the risk by 2.76.
This shows that regardless of gender, the risk increases by the number of cigarettes, but the increased risk in male heavy smokers is still lower than the increased risk observed in female light smokers. Therefore female smokers appear to be more vulnerable to haemorrhagic strokes than men.
Was there only bad news?
However, good news was also found in the study. It showed that smoking cessation significantly reduced the risk of getting a subarachnoid haemorrhage. After 6 months without smoking, there was no longer an increased risk in male or female smokers, and their risk of haemorrhagic stroke was the same as non-smokers.
These results therefore seem to show how important it is to stop smoking cigarettes and find other and healthier habits to reduce the risk of life-threatening conditions.
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