Hemorrhagic stroke Health Article

Definition

Hemorrhagic stroke involves bleeding within the brain, which damages nearby brain tissue.

See also:

• Cerebral aneurysm
• Deep intracerebral hemorrhage
• Hypertensive intracerebral hemorrhage
• Intracerebral hemorrhage
• Lobar intracerebral hemorrhage
• Subarachnoid hemorrhage

Alternative Names

Brain bleeding; Brain hemorrhage; Stroke - hemorrhagic; Hemorrhagic cerebrovascular disease

Causes, incidence, and risk factors

Hemorrhagic stroke occurs when a blood vessel bursts inside the brain. The brain is very sensitive to bleeding and damage can occur very rapidly. Bleeding irritates the brain tissue, causing swelling. Bleeding collects into a mass called a hematoma. Bleeding also increases pressure on the brain and presses it against the skull.

Hemorrhagic strokes are grouped according to location of the blood vessel:

• Intracerebral hemorrhage: Bleeding in the brain
• Subarachnoid hemorrhage: Bleeding in the area between the brain and the thin tissues that cover the brain

Hemorrhagic stroke is most often due to high blood pressure, which stresses the artery walls until they break.

Other causes of hemorrhagic stroke include:

• Aneurysms, which create a weak spot in an artery wall, which can eventually burst
• Abnormal connections between arteries and veins, such as an arteriovenous malformation (AVM)
• Cancer, particularly cancer that spreads to the brain from distant organs such as the breast, skin, and thyroid
• Cerebral amyloid angiopathy, a build up of amyloid protein within the artery walls in the brain, which makes bleeding more likely
• Conditions or medications (such as aspirin or Warfarin) that can make you bleed excessively
• Illicit drugs, such as cocaine

Symptoms

The symptoms vary depending on the location of the bleed and the amount of brain tissue affected. Symptoms usually develop suddenly, without warning, and often during activity. They may come and go (be episodic) or slowly get worse over time.

Symptoms may include:

• Change in alertness (level of consciousness)
  • Apathetic
  • Coma
  • Lethargy
  • Sleepiness
  • Stupor
  • Unconsciousness
  • Withdrawn
• Difficulty speaking or understanding others
• Difficulty swallowing
• Difficulty writing or reading
• Headache
  • Occurs when lying flat
  • Wakes you up from sleep
  • Gets worse when you change positions or when you bend, strain, or cough
  • Starts suddenly
• Loss of coordination
• Loss of balance
• Movement changes, usually on only one side of the body
  • Difficulty moving any body part
  • Loss of fine motor skills
• Nausea or vomiting
• Seizure
• Sensation changes, usually on only one side of the body
  • Decreased sensation
  • Numbness or tingling
• Weakness of any body part
• Vision changes
  • Decreased vision
  • Loss of all or part of vision