New BrainPath® Technology for Treating Hemorrhagic Stroke Now Available at Nebraska Medicine – Nebraska Medical Center

Andrew Gard, MD

There are two common types of strokes, ischemic and hemorrhagic (bleeding) stroke. Ischemic stroke is the most common type of stroke, accounting for the majority of stroke cases. Although hemorrhagic strokes account for only 15 percent of all stroke cases, it is the deadliest form of stroke. The location of the bleeding is an important factor in determining the cause of the stroke, as well as the treatment.

Bleeding within the fluid-filled space surrounding the brain is called a subarachnoid hemorrhage. A common cause of subarachnoid bleeding is a ruptured brain aneurysm. Please see our previous post regarding brain aneurysms.

When you come to Nebraska Medicine, you can be sure you will receive the best care available from a highly skilled and dedicated stroke team, providing you or your loved one the best chance for a full recovery. Nebraska Medicine – Nebraska Medical Center is the only certified Comprehensive Stroke Center in the state.

Bleeding within the brain substance itself is called an intracerebral hemorrhage (ICH). ICH can be due to a blood vessel bursting within the brain tissue. The bleeding causes injury directly to the brain by destroying brain cells along its path, but also indirectly by forming a thick clot which causes pressure injury to the brain tissue surrounding the blood clot. As the body tries to dissolve the blood clot, there may also be swelling around the clot, as well as an irritating chemical reaction with the breakdown of the clot. Both of these processes lead to poor outcomes in patients with hemorrhagic stroke.

The location of the bleeding is an important factor in determining the cause of the stroke, as well as the treatment.

For large, symptomatic ICH, surgery may be indicated to improve survival and progression. For many years, surgery for hemorrhagic stroke was limited because these bleeds are often deep within the brain. Surgically accessing these deep hemorrhages previously involved large openings with possible injury to the overlying brain tissue.

Now at Nebraska Medicine – Nebraska Medical Center, we have newer technology that allows for a minimally invasive approach to evacuating deep symptomatic ICH. This minimally invasive approach utilizes small tubular retractors (BrainPath) to gently spread the brain fibers apart as well as improved visualization. These tools allow us to evacuate the clot and reduce brain injury from the clot itself. After treating the patient for ICH, we continue to identify and correct risk factors for future stroke, including high blood pressure, bleeding disorders or other structural abnormalities.

To schedule an appointment with a Nebraska Medicine stroke specialist, call 800.922.0000.


About the Author

Andrew Gard, MD

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