A hemorrhagic stroke occurs when a ruptured blood vessel disrupts blood flow to part of your brain. It is a medical emergency. Recognizing symptoms and seeking immediate treatment can help improve your outlook.

A stroke occurs when blood flow to a part of the brain is cut off or significantly reduced, causing brain cells to die and leaving permanent brain damage.

This most often occurs due to a blockage that prevents blood from reaching brain tissue. But it can also occur due to a rupture in a blood vessel in the brain. When this happens, it’s known as a hemorrhagic stroke.

A hemorrhagic stroke occurs when a blood vessel ruptures and blood accumulates in the tissue around the rupture. This puts pressure on the brain, causing blood loss to the surrounding areas.

Different areas of your brain control different functions. When a hemorrhagic stroke affects a specific part of your brain, functions controlled by that part of the brain will also be affected.

Types of hemorrhagic stroke

There are two types of hemorrhagic strokes:

  • intracerebral hemorrhage (ICH): bleeding affects your functional brain tissue
  • subarachnoid hemorrhage (SAH): bleeding affects the layer around your brain containing cerebrospinal fluid

ICH is about three times as common as SAH, according to 2019 global data. ICH is also typically more serious than SAH.

Hemorrhagic stroke vs. ischemic stroke

About 13% of strokes are hemorrhagic strokes, which are due to a ruptured blood vessel in the brain.

But the majority of strokes are ischemic. These occur when a blockage, like a blood clot or plaque, narrows the arteries supplying blood to the brain.

Although less common than ischemic strokes, hemorrhagic strokes often have less favorable outcomes.

Learn more about the differences between ischemic and hemorrhagic strokes.

Symptoms of a hemorrhagic stroke can vary from person to person, but they’re almost always present immediately after the stroke occurs.

Symptoms may include:

  • total or limited loss of consciousness
  • nausea
  • vomiting
  • sudden and severe headache
  • weakness or numbness in the face, leg, or arm on one side of the body
  • seizures
  • dizziness
  • loss of balance
  • problems with speech or swallowing
  • confusion or disorientation

While ischemic and hemorrhagic strokes share many symptoms, some symptoms may be more likely to occur with a hemorrhagic stroke. For example, a 2017 study found that headaches and seizures were more likely among people who had a hemorrhagic stroke.

Stroke is a medical emergency

A stroke is a medical emergency. Call 911 or your local emergency services or have someone drive you to the hospital if you think you’re having a stroke.

There are two possible causes of a ruptured blood vessel in the brain.

The most common cause is an aneurysm. An aneurysm occurs when a section of a blood vessel becomes enlarged from chronic and dangerously high blood pressure or when a blood vessel wall is weak, which is usually congenital. This ballooning leads to thinning of the vessel wall and, ultimately, to a rupture.

A rarer cause of an ICH is an arteriovenous malformation (AVM). This occurs when arteries and veins are connected abnormally without capillaries between them. AVMs are congenital, meaning they’re present at birth but not hereditary. It’s unknown exactly why they occur in some people.

Immediate emergency care is crucial for a hemorrhagic stroke. This treatment focuses on controlling the bleeding in your brain and reducing the pressure caused by the bleeding.

Doctors can use medications to reduce blood pressure or slow down the bleeding. If you experience a hemorrhagic stroke while on blood thinners, you’re at particular risk for excessive bleeding. Doctors will usually give medications to counteract the effect of the blood thinners right away during emergency treatment.

Once doctors bring a hemorrhagic stroke under control with emergency care, they can take further treatment measures. If the rupture is small and produces only a small amount of bleeding and pressure, supportive care may be the only other form of care you need. This may include:

  • intravenous (IV) fluids
  • rest
  • management of other medical problems

Surgical treatment for hemorrhagic stroke

For more severe strokes, you may need surgery to repair the ruptured blood vessel and stop the bleeding.

If the stroke is due to an AVM, doctors may surgically remove it. But this isn’t always possible as it depends on the location of the AVM.

You may also need surgery to relieve pressure caused by the bleeding and brain swelling.

The duration of recovery and rehabilitation depends on the severity of the stroke and the amount of tissue damage that occurred. Depending on your needs, different types of therapy may be involved to restore as much function as possible.

Options include:

Your outlook for recovery after a hemorrhagic stroke depends on the severity of the stroke, the amount of tissue damage, and how soon you were able to get treatment. Other factors that may influence your outlook include:

The recovery period is long for many people, lasting for months or even years. However, most people with small strokes and no additional complications during the hospital stay can function well enough to live at home within weeks.

What is life expectancy after a hemorrhagic stroke?

How long you can live after a hemorrhagic stroke depends on several factors.

In a large 2019 Swedish study, 69.3% of people who had an ICH were still alive after 30 days.

The same study found that 37.8% of people who had an ICH were alive after 5 years, compared to 64.6% of their peers who did not have a stroke.

Controlling certain risk factors for hemorrhagic stroke can help reduce your odds of experiencing odd.

High blood pressure is the most likely cause of an ICH. Keeping your blood pressure under control is one of the best ways to control your risk. Talk with a doctor about how to lower your blood pressure if it’s too high.

Alcohol and drug use are also controllable risk factors. Consider drinking in moderation and avoid any type of substance use.

Blood thinners help prevent ischemic strokes but can also increase your odds of having an ICH. If you’re on blood thinners, be sure to speak with your doctor about the risks.

Hemorrhagic strokes occur when a ruptured blood vessel disrupts blood flow to a part of your brain. Your symptoms will depend on the part of the brain affected, but they typically involve headache, weakness or numbness on one side of the body, and difficulty speaking.

While hemorrhagic strokes are less common than ischemic strokes, they tend to have a less favorable outcome. Prompt treatment is necessary to reduce the risk of death or long-term complications.