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From YouTube: Community Health Education - Hemorrhagic Stroke
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A
Hi
I'm
Vanessa
Gormley
I'm,
one
of
the
nurses
at
the
Massachusetts
General
Hospital
fireman
vascular
Center.
You
may
have
remembered
me
from
previous
segments
that
we've
done
with
Chelsea
cable
access,
where
we
talked
a
little
bit
about
ice,
quemic,
stroke
and
healthcare
proxies
today.
We're
actually
going
to
be
speaking
about
hemorrhagic,
strokes
and
I.
Have
one
of
my
colleagues
here:
Cristina
Matthews
who's,
a
nurse
practitioner
with
us,
and
we
actually
have
a
survivor
here
today:
Chelsea
Zone,
Terry
Curtis.
So,
let's
start
off
with
actually
just
identifying
Cristina.
What
is
a
hemorrhagic
stroke
thanks.
B
Vanessa,
it's
really
great
to
be
here.
A
hemorrhagic
stroke
basically
just
means
bleeding
into
the
brain,
I.
Think
in
your
previous
segment,
you
talked
a
little
bit
about
ischemic
stroke,
which
is
a
blockage
block
in
one
of
the
vessels
in
the
brain.
When
we're
talking
about
hemorrhagic
stroke,
we're
talking
about
bleeding
into
the
brain
a
little.
A
B
B
A
B
Normally,
when
we're
looking
or
assessing
or
valuating
a
patient
who
comes
in
with
a
subarachnoid
hemorrhage,
that's
usually
due
to
bleeding
because
of
a
vessel
of
some
kind.
So
it
may
be
what
we
call
in
our
tario
venous
malformation,
abbreviated
AVM,
which
basically
is
a
tangle
of
blood
vessels
that
bleeds
or
what
many
people
may
have
heard
of
in
the
past,
which
is
an
aneurysm
which
is
a
little
bubble
on
one
of
the
vessels
that
pops
and
bleeds.
B
B
So
you
will
probably
the
the
most
common
symptom,
the
one
that
almost
every
patient
will
say
that
they
experience
when
they
have
a
subarachnoid.
Hemorrhage
is
the
worst
headache
of
their
life.
That's
across
the
board.
Almost
everyone
will
tell
me
that
I
have
I
felt
the
worst
headache
of
my
life.
Many
times
they
may
experience
additional
symptoms,
so
some
other
symptoms
come
along
with
that
which
may
be
neck
stiffness.
They
may
get
nausea
and
vomiting.
They
may
get
severe
pain
behind
the
eyes.
B
A
So,
if
I'm
having
all
of
the
sudden,
this
really
significant
headache,
worse
than
I've
ever
had
before,
along
with
either
this
neck
stiffness
or
that
sudden
pain
that
kind
of
comes
along,
it's
not
just
the
headache.
It's
the
pain
above
the
eye
or
sudden
double
vision.
I
need
to
do
something
absolutely.
B
B
Much
faster
and
there
will
also
be
evaluating,
assessing
trying
to
figure
out
what's
wrong
with
you
on
the
way
to
the
hospital
and
they're
talking
with
the
doctors
in
the
emergency
room
on
the
way,
so
that
we're
already
getting
a
lot
of
information
about
what
happened
to
you
before
you
even
get
there.
Also
things
can
move
much
faster
exactly
so.
When
you
arrive,
we've,
we've
already
got
things
going.
We
already
know
what
we're
expecting
and
we
can
already
get
ready
to
do
what
needs
to
be
done
to
help
you
be
well.
Okay,.
A
B
Normally,
when
you
arrive
there
will
be
nurses,
doctors
ready
to
look
you
over
to
do
an
exam
to
try
to
figure
out
what's
happening.
What
what
symptoms
did
you
experience,
which
is
when
you'll
tell
us?
It
was
that
worst
headache
of
my
life
that
came
on
suddenly
and
any
other
symptoms
that
you
may
be
have
it
will
get
a
little
bit
of
history
from
you
will
talk
to
your
family
members
and
try
to
determine
what's
been
going
on,
you'll,
probably
see
a
neurosurgeon,
it's
to
be
expected.
B
We
want
to
make
sure
if
there
truly
is
some
bleeding
what's
happening
and
more
than
likely
one
of
the
first
things
that
will
happen
is
you'll
get
a
cat
scan.
So
we
will
take
you
into
a
scanner
where
we'll
do
some
imaging
of
your
brain
to
try
to
really
get
a
good
look
and
assess?
Is
there
truly
a
hemorrhage
there,
and
if
there
is
what
type
of
hemorrhage
is
it
like
we
spoke
of
earlier?
A
B
Once
we
determine
with
for
sure
that
there
is
bleeding
and
that
it
is
due
to
either
an
AVM
in
our
tario
venous
malformation,
which
is
that
tangle
of
blood
vessels
or
an
aneurysm,
which
is
that
bubble
that
popped
once
we
see
either
one
of
those
two
things
we're
going
to
then
put
in
place
the
steps
to
fix
it.
So
our
first
step
is
to
make
sure
that
you're
stable
to
make
sure
that
you're
safe
to
make
sure
that
everything
is
okay.
Then
we're
going
to
start
to
plan
out.
B
How
do
we
need
to
make
sure
the
bleeding
has
stopped,
and
how
do
we
prevent
that
bleeding
from
happening
again?
So
more
than
likely
we'll
need
to
do
a
procedure,
a
surgery,
perhaps
of
some
kind
to
protect
you
from
that
happening
again
so
to
repair
to
fix
the
vessel
that
has
bled
and
to
make
sure
that
we,
it
doesn't
happen
in
the
future.
Okay.
A
B
So
there
there
are
two
ways
that
we
can
do
surgeries
to
repair
these
vessels.
One
is
where
we
actually
have
to
do.
A
surgery
called
a
craniotomy,
which
is
where
we
actually
have
to
open
up
the
skull.
The
other
is
where
we
can
actually
go
in
through
the
vessel,
so
the
femoral
artery,
which
sits
at
the
top
of
your
thigh,
will
go
in
to
that
vessel
and
just
get
right
up
to
where
the
bleeding
has
occurred,
to
either
the
AVM
or
the
aneurysm
and
repair
it
either
way.
B
What
we're
trying
to
do
is
repair
that
vessel,
so
that
no
bleeding
occurs
again
in
the
future.
It
may
be
a
long
hospital
stay
for
somebody.
Who's
had
a
hemorrhage
of
bleeding
of
this
type,
normally
they're
in
the
hospital
with
us
for
about
two
weeks
or
so
there's
many
reasons
why
we
do
that.
Ultimately,
the
goal
is
to
make
sure
that
you're
safe
and
that
we've
taken
care
of
everything
to
prevent
another
bleed
in
the
future.
I.
A
B
So
so,
normally,
prior
to
anyone
going
home
after
they've
had
a
hemorrhage
or
a
bleed
in
the
brain,
we
are
sure
to
have
physical
therapy
occupational
therapy.
The
therapists
come
and
really
do
a
very
thorough
assessment
really
see
how
you're
doing
can
you
walk?
Can
you
get
yourself
to
the
bathroom
safely
alone?
Can
you
fix
yourself
a
snack?
Can
you
get
a
drink
of
water?
B
If
there's
any
question,
we
may
recommend
going
to
a
rehab
facility
to
help
you
recover
and
get
back
the
ability
to
do
those
things
and
then
some
of
the
things
that
people
experience
even
going
forward
after
being
discharged
some
problems
with
memory,
sometimes
some
problems
with
concentration,
sometimes
there's
a
little
bit
of
sensitivity,
so
difficulty
dealing
with
bright
lights
and
and
crowds
and
loud
noises,
and
those
things
can
take
a
little
bit
of
time
to
get
better.
Okay,.
A
So
this
is
really
similar
to
when
we
chatted
last
time
about
a
nice
quemic
stroke
where
a
lot
of
times
after
that
injury
to
the
brain
it
takes.
You
know
a
while
for
you
to
kind
of
get
over
that
injury.
You
know
you
have
this
newly
acquired
brain
injury
and
there's
a
lot
that
kind
of
comes
with
it.
I
think
it's
a
wonderful
time
to
bring
in
our
survivor
Terry
to
really
tell
her
story
about
what
happened
to
you
and
how
you
felt
in
the
recovery
process.
Sure.
C
Well,
over
30
years
ago,
I
was
at
work
and
didn't
feel
well
and
I
before
I
knew
it.
I
woke
up
in
a
hospital
at
which
point
I
was
diagnosed
with
an
AVM
and
over
a
two-year
period,
I
had
several
procedures
to
reduce
the
size
and
then
remove
the
AVM
and
for
about
30
years,
I
recovered
I've
covered,
probably
over
a
two-year
period.
I
had
a
lot
of
recovery
and
then
I
led
a
really
great
wonderful.
C
Normal
life
was
able
to
work
and
live
fully
and
two
years
ago,
I
was
in
a
hotel
by
myself
and
getting
ready
for
bed.
I
sneezed
and
I
suddenly
felt
that
worst
headache
of
my
life
that
Christina
had
explained
and
I
noticed
that
I
started
to
go
numb
on
the
right
side
of
my
body
and
I
realized.
I
felt
a
terror
and
I
realized
that
I
was
in
a
lot
of
trouble
and
I
got
to
the
phone
in
the
room
and
I
realized.
C
I
couldn't
really
see,
but
having
dialed
the
phone
many
times
I
was
able
to
get
the
front
desk
and
say:
I
need
911,
I
need
an
ambulance
and
they
arranged
that
and
I
was
brought
to
a
hospital
and
then
I
was
transferred.
I
was
in
a
different
state
at
the
time,
and
I
was
transferred
closer
to
home
to
MGH,
and
they
took
very
good
care
of
me
and
it
took
a
while
to
recover
from
that.
I
had
some
visual
problems
and
time.
C
A
Such
an
amazing
story,
yeah
I,
think
it's
a
good
reminder
for
so
many
of
us
to
really
make
sure
that
when
we
have
symptoms
that
just
aren't
right
and
you're
feeling
scared
and
you're
nervous,
you
should
never
go
back
to
bed.
Thank
God,
you
you
call
9-1-1.
You
called
to
the
hotel
operator
to
say
get
me
help
right
away.
A
If
you
didn't
self
advocate
or
make
sure
that
someone
was
going
to
take
care
of
you
at
that
moment,
and
if
you
decided
to
go
back
to
sleep
I
mean
you
might
not
be
here
with
us
right
now.
So
it's
really
tremendous
that
you
identified
that
something
was
wrong,
that
this
headache
was
not
common
for
you
and
you
got
the
help
that
you
needed
in
terms
of
your
recovery.
Did
you
participate
in
any
of
that
physical
therapy
or
speech
therapy?
That
Christina
had
mentioned
I
I.
C
Didn't
need
any
event.
I'm
close
to
my
release
from
the
hospital
I
did
have
a
an
occupational
therapist
come
and
assess
me
and
did
all
the
things
she
described
and
made
sure
I
was
able
to
do
things
to
take
care
of
myself
and
since
I
was
able
to
do
that,
I
was
released
that
the
things
after
that
that
that
I
noticed
that
what
different
about
me
as
a
person
or
that
you
know
a
lot
of
stimulation
was
very
difficult
to
deal
with
initially
and
that's
gotten
better
over
time.
C
B
And
I
think
that
that's
one
of
the
things
that
we
see
that's
very
challenging
is
that
the
recovery
can
be
a
long
process.
It's
not
a
recovery.
That's
days
and
weeks.
It
can
sometimes
be
a
recovery,
that's
months
and
even
into
one
to
two
years,
eighteen
months,
two
years
to
really
start
to
feel
like
you're
yourself
again,
like
you've
kind
of
that
fog
so
to
speak,
has
lifted
and
you've
turned
that
corner.
That
must.
B
That's
an
wonderful
point,
Vanessa
and
I.
Think
one
that
sometimes
people
aren't
readily
aware
of
don't
see
immediately.
Is
that
there's
no
cast
on
your
leg?
There's
no
broken
bone.
There's
no
visual
sign
obvious!
When
you
look
at
someone
that
something
has
happened,
because
it's
all
in
the
brain,
so
I
think
it's
important,
and
maybe
you
struggled
with
this
a
little
bit
teri
that
that
people
realize
that,
even
though
the
person
looks
the
same
there's
a
lot
of
recovery
going
on
there
there's
been
a
significant
injury
and
there's
still
a
lot
of
recovery
happening.
Mm-Hmm.
C
That's
I
would
agree
that
you
know
many
people
say
to
me:
you
look
like
there's
nothing
wrong
and
but
inside
you
know
initially,
particularly
in
the
very
beginning,
you
know
you're
feeling
like
but
I'm,
but
I'm
not
the
same,
and
you
know
you're
different,
but
you
don't
always
know
how
to
say
it
like.
This
is
what's
different
about
me.
You
just
know
that
you're
having
some
difficulties
and
challenges
that
aren't
visible
to
everybody,
yeah.
D
A
B
It's
really
not
it's
really
not
and
I
think
that
it's
important
to
seek
out
resources.
You
know
support
groups.
There's
there's
Terry
comes
to
our
support
group
at
Mass
General,
which
is
wonderful
there.
There
are
resources
out
there
and
seeking
those
you
know,
trying
to
talk
to
people
talk
to
your
providers,
the
doctors,
the
nurses
ask
who
can
I
do?
Is
there
anyone
I
can
talk
to?
Who
can
help
me
with
this?
B
A
A
I
think
that's
where
you
know
your
expertise
and
support
comes
in
to
Cristina,
because
maybe
you
know
a
general
practitioner,
you
know
a
general
doctor
might
not
have
all
this
information
or
or
maybe
doesn't
have
any
experience
with
an
aneurysm
or
AVM
survivor,
hemorrhagic,
stroke
survivor
who
comes
in
and
is
experiencing.
All
of
these
you
know
anxieties
or
changes
in
their
brain
and
how
they
kind
of
cope
with
day-to-day
living.
Where
you
and
neurosurgery,
seeing
this
all
the
time
you
kind
of
know
about
you,
you've
experienced
this
with
some
of
your
other
patients.
A
B
A
Sure,
well,
thank
you
both
for
being
here
today
to
educate
the
Chelsea
community
on
hemorrhagic
stroke
and
in
Terry
thanks
so
much
for
sharing
their
story.
You
know
you
could
be
saving
a
life
100%
with
sharing
what
you
did,
what
you
went
through
in
your
recovery.
So
thank
you
very
much.
Thank
you
all
for
watching
just
to
briefly
recap
and,
as
you
know,
there's
going
to
be
our
slides
directly
after
this
segment
that
you
can
review.
A
So
we
discussed
hemorrhagic
stroke,
the
two
main
types
of
that
bleeding
in
the
brain,
which
is
the
intra
cerebral
hemorrhage
so
bleeding
inside
the
brain,
and
that
subarachnoid
hemorrhage,
which
is
kind
of
bleeding
into
a
very
specific
area.
The
subarachnoid
hemorrhages
are
primarily
caused
by
those
aneurysms
or
the
arteriovenous
malformations.
A
The
interest
cerebral
hemorrhages
can
often
be
caused
by
anything
from
high
blood
pressure.
That's
really
poorly
controlled,
maybe
you're
not
taking
your
medications
as
well
as
you
should,
or
maybe
even
something
like
trauma
like
a
fall
or
a
car
accident.
We
talked
about
the
significant
importance
of
anytime.
You
have
a
sudden
symptom
of
worst
headache
of
your
life,
that
sudden
double
vision
or
or
that
sudden
numbness
on
one
side
of
your
body,
the
sudden
inability
to
be
able
to
speak
that
you
really
need
to
call
9-1-1
right
away.
A
Don't
mess
around,
don't
ask
for
help,
don't
fall
back
to
sleep,
call
the
people
that
can
take
you
to
a
hospital
as
soon
as
possible,
and
then
we
talked
a
little
bit
about
the
treatment
options.
The
good
news
is
that
we
can
stop
the
bleeding
in
your
brain.
We
can
help
you
get
better
and
you
can
have
a
really
tremendous
recovery
like
Terri
has
had
twice
so
you
we.
There
are
plenty
of
things
that
we
can
do
at
the
hospital
to
help
you.
A
So
please,
please,
please
make
sure
you
get
to
the
hospital
right
away,
doesn't
matter
which
one,
because
if
that
hospital
doesn't
take
care
of
of
bleeding
in
the
brain,
you'll
be
transferred
to
one
that
can
and
I
think
we
talked
a
little
bit
about,
maybe
some
risk
factors,
but
just
to
review
them
really
quickly.
Some
risk
factors
for
bleeding
inside
of
the
brain.
It
could
be
anything
from
drug
abuse,
alcohol
abuse,
like
I
mentioned
before,
that
high
blood
pressure
am
I
missing
any
Christmas.
A
B
Should
speak
with
your
provider
about
it
for
sure
speak
with
your
doctor,
you
can
speak
with
your
primary
care
doctor
just
just
to
see
if,
if
there
truly
is
an
increased
risk
for
you
and
then
with
a
simple
image,
a
cat
scan,
we
can
try
to
see
if
any
of
those
things
exist
before
they
become
a
problem
before
they
become
a
hemorrhage
or
bleeding
in
the
brain.
Okay,
so.