What is hemorrhagic stroke?

A hemorrhagic stroke occurs when an aneurysm bursts in the brain or if you have a weakened blood vessel in the brain. As blood leaks into the brain, it can cause swelling and pressure in the brain, which can damage or kill brain cells.

Although only approximately 15 percent of strokes are hemorrhagic strokes, they lead to more than 40 percent of the deaths from strokes.

Ischemic Stroke Stroke

Types of hemorrhagic stroke

Intracerebral hemorrhage

A type of bleed that occurs within the brain tissue and ventricles.

Subarachnoid hemorrhage

A type of bleed that occurs just outside the brain

Causes of hemorrhagic stroke

Causes of hemorrhagic stroke vary based on the type of hemorrhagic stroke you have experienced.

An intracerebral hemorrhage occurs when a blood vessel in the brain bursts and blood leaks into the brain cells. As the blood leaks, it damages and kills brain cells. Patients with high blood pressure or older patients are most likely to suffer an intracerebral hemorrhage.

A subarachnoid hemorrhage occurs when there is bleeding in the space between the brain and the tissues surrounding the brain. This type of stroke typically occurs from an aneurysm bursting but can also occur from a head injury, blood thinners or a bleeding disorder.

There are two types of hemorrhagic strokes

Risk factors for hemorrhagic strokes

Risk factors for hemorrhagic strokes vary based on the type of hemorrhagic stroke you are experiencing.

Risk factors for intracerebral hemorrhage include:

  • Older age
  • Gender
  • High blood pressure (hypertension)
  • Excessive alcohol intake
  • Having an AVM (arteriovenous malformations) — An AVM is a genetic condition that occurs when the blood vessels do not form correctly

Risk factors for subarachnoid hemorrhage include:

  • Smoking
  • High blood pressure (hypertension)
  • Alcohol abuse
  • Having an AVM (arteriovenous malformations) — An AVM is a genetic condition that occurs when the blood vessels do not form correctly

Symptoms of hemorrhagic stroke

The main symptoms of a hemorrhagic stroke include:

  • Severe headache that comes on suddenly
  • Changes in vision
  • Seizure
  • Numbness in arms and legs
  • Inability to move
  • Confusion
  • Nausea
  • Vomiting
  • Losing consciousness

Diagnosis of hemorrhagic stroke

If you have symptoms of a stroke, call 911 immediately.

Your doctor can diagnose a hemorrhagic stroke by evaluating your signs in a physical exam and ordering a CT (computed tomography) scan. A CT scan is the most effective way to quickly diagnose a hemorrhagic stroke. Your doctor may also order other tests to diagnose a hemorrhagic stroke including:

  • Magnetic resonance imaging (MRI) scan — an MRI can take detailed images of the brain to locate where the stroke is occurring
  • Blood tests — can rule out other causes of symptoms
  • MRI angiography — a MRI where contrast dye is injected into the vessels to amplify any abnormalities in the brain

Treatment for hemorrhagic stroke

Immediate treatment for hemorrhagic stroke is crucial. Early intervention will concentrate on stabilizing the vital signs and controlling the bleeding in the brain.

Treatments include:

Medications

Medications, including anticonvulsants which help prevent seizures, antihypertensive agents which help reduce blood pressure, and osmotic diuretics which help reduce pressure in the brain.

Surgical treatments

If the stroke was severe, surgical intervention may be required to fix the blood vessel that ruptured and stop the bleeding. In cases where an AVM caused the stroke, when possible, the AVM may be removed. In other cases, surgery may be indicated to relieve swelling in the brain caused by the bleeding.

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