Massive Stroke: Symptoms, Treatment, and Long-Term Outlook

Written by Mary Ellen Ellis | Published on February 10, 2014
Medically Reviewed by George T. Krucik, MD, MBA on February 10, 2014

Stroke: An Overview

A stroke is what happens when blood flow to part of the brain is interrupted. The result is oxygen deprivation to brain tissue, which can have devastating consequences. The ability of a patient to recover from a stroke depends on the severity of the attack, as well as how quickly medical attention is provided. A massive stroke can be fatal, but for many patients experiencing a stroke, recovery is long, but possible.

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Hemorrhagic Stroke

There are two main types of stroke: hemorrhagic and ischemic. A hemorrhagic stroke occurs when blood vessels in the brain rupture, causing blood to accumulate in the surrounding brain tissue. This causes pressure on the brain, which can be problematic. The rupture can also leave part of the brain deprived of blood and oxygen. Only 13 percent of strokes are hemorrhagic, according to the American Stroke Association.

Ischemic Stroke

The majority of strokes are ischemic. An ischemic stroke results from a clot that blocks blood flow to a particular region of the brain. The clot may be a cerebral thrombosis, meaning it forms at the site of the blockage in the brain. Alternatively, the clot may be a cerebral embolism, which means it forms elsewhere in the body and moves into the brain, causing a stroke.

Severity of Strokes

Strokes can range from minor and almost unnoticeable to massive and fatal. The National Institutes of Health created a tool used by health professionals to measure the severity of a stroke. It uses a number score to rate the severity of the symptoms, and therefore the severity of the stroke.

Symptoms measured by the scale include consciousness, eye movement, facial palsy, arm and leg mobility, sensation, language, and speech. Points on the scale range from zero to 42, with a rating from 21 to 42 indicating a severe, or massive, stroke.

Symptoms of a Massive Hemorrhagic Stroke

A hemorrhagic stroke may occur within the brain or on the surface of the brain. Symptoms of the former include a severe headache, confusion, nausea, vomiting, and seizures. The more severe these symptoms, the more massive the stroke is.

If the stroke occurs on the surface of the brain, symptoms are slightly different. These symptoms may include headache, vomiting, neck stiffness, loss of vision, or in severe cases, rigidity and coma. Symptoms of hemorrhagic strokes begin suddenly, but often worsen over the course of a few hours.

Symptoms of a Massive Ischemic Stroke

An ischemic stroke often begins with a sudden severe headache, dizziness and loss of balance or coordination, blurred vision, numbness and weakness in one side of the face and body, sudden confusion, and difficulty talking. The severity of symptoms depends how massive the stroke is.

Emergency Treatment for a Massive Hemorrhagic Stroke

In order to slow the bleeding caused by a hemorrhagic stroke, emergency caregivers may give a patient medications to lower blood pressure. If the patient has been on blood thinners, he or she may be given drugs to counteract them, as these medications worsen bleeding.

A patient experiencing a hemorrhagic stroke may need emergency surgery, depending on the severity of the bleeding. This is done to repair the broken blood vessel and to remove excess blood that may be putting dangerous pressure on the brain.

Emergency Treatment for a Massive Ischemic Stroke

Emergency care for a stroke must be administered as soon as possible. The promptness of treatment is important for recovery. The sooner treatment can be given, the better the odds of survival and recovery. For an ischemic stroke, emergency care involves targeting and dissolving the clot. Clot-busting drugs called thrombolytics are often used for this purpose.

Before this kind of treatment can be given, however, caregivers must confirm that the stroke is not hemorrhagic. Blood thinners can make a hemorrhagic stroke worse and even kill the patient.

Recovering from a Massive Stroke

Recovery from a massive stroke is a long struggle. Complications and resulting impairments become more serious depending on the severity of the stroke. A massive stroke can result in paralysis, loss of muscle control, pain, difficulty with language and speaking, trouble with memory and thinking, and emotional issues.

Rehabilitation services can help minimize complications and may include working with a physical therapist to restore movement, an occupational therapist to learn how to perform daily tasks, a speech therapist to improve speaking ability, and psychologists.

The Long-Term Outlook

The prognosis for a stroke patient depends on the severity of the incident and how quickly medical care is given. The outlook is better for an ischemic stroke. Hemorrhagic strokes have more complications, such as the pressure put on the brain from the ruptured blood vessel.

According to the University of Maryland Medical Center, more than three-quarters of patients survive after the first year, and more than half survive after five years. The odds of survival and recovery become lower with more massive strokes.

Preventing a Stroke

There are risk factors for stroke that can be avoided, and preventive measures that can be taken. Having high blood pressure, drinking too much alcohol, using drugs, and smoking all increase the risk of having a stroke. Being on blood thinners increases the risk of having a hemorrhagic stroke. If you must take blood thinners, speak to your doctor about minimizing your risk of having a stroke.

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