What is hemorrhagic stroke?

The most common symptom of hemorrhagic stroke is a sudden and severe headache. Many people describe it as "the worst headache of my life."

If you have any stroke symptoms, call 911 or other emergency services right away.

• Stroke symptoms include:
  • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
  • Sudden vision changes.
  • Sudden trouble speaking.
  • Sudden confusion or trouble understanding simple statements.
  • Sudden problems with walking or balance.
  • A sudden, severe headache that is different from past headaches.
  • Fainting.
  • A seizure.

Other symptoms include:

• Nausea and vomiting.
• Neck stiffness.
• Dizziness.
• Changes in mental state, such as irritability or confusion.

Treatment includes efforts to control bleeding, reduce pressure in the brain, and stabilize vital signs, especially blood pressure.

• To stop the bleeding, you may be given medicine or a transfusion of parts of blood, such as plasma. These are given through an I.V.
• You will be closely monitored for signs of increased pressure on the brain. These signs include restlessness, confusion, trouble following commands, and headache.
• If the bleeding is due to a ruptured brain aneurysm, surgery or a procedure to repair the aneurysm may be done.
• In some cases, medicines may be given to control blood pressure, brain swelling, blood sugar levels, fever, and seizures.
• If a large amount of bleeding has occurred and symptoms are quickly getting worse, you may need surgery to remove the blood that has built up inside the brain and to lower pressure inside the head.

Ask your doctor if a stroke rehab program is right for you. Starting a rehab program can help you recover. And it may help you regain abilities that you may have lost.

• Work with your doctor to manage other health problems, such as high blood pressure.
• Be safe with medicines. Take your medicine exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Have a healthy lifestyle.
  • Do not smoke or allow others to smoke around you. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • Limit alcohol to 2 drinks a day for men and 1 drink a day for women.
  • Be active. Ask your doctor what type and level of activity is safe for you.
  • Eat heart-healthy foods, like fruits, vegetables, lean meat, fish, or whole grains.
  • Stay at a healthy weight. Lose weight if you need to.
• Get vaccinated against COVID-19, the flu, and pneumonia.
• If you think you may have a problem with alcohol or drug use, talk to your doctor.

Treatment for hemorrhagic stroke may include a surgical or catheter procedure to:

• Drain or remove blood that is in or around the brain.
• Repair a brain aneurysm. This may be done with either:
  • Endovascular procedure. The doctor uses a thin tube, called a catheter, inside blood vessels to insert soft metal coils or mesh into the aneurysm to block it off. This can stop or prevent bleeding.
  • Craniotomy surgery. Through a cut in the skull, the doctor places a small metal clip around the base of the aneurysm to block it off. This stops the bleeding in the brain.
• Remove or block off abnormally formed blood vessels (arteriovenous malformation) that have caused bleeding in the brain.

Your age, prior overall health, and current condition are major factors in the decision about having surgery or a procedure.

A hemorrhagic stroke occurs when weakened blood vessels burst or leak. Causes of weakened blood vessels in the brain include:

• A brain aneurysm. This is a bulging, weak part of a blood vessel. It can put pressure on nerves, or it can bleed or break open (rupture).
• A brain AVM. This is an abnormal knot of weak blood vessels that some people are born with.
• Head injury.
• Chronic uncontrolled high blood pressure. Blood pressure that is too high over the long term increases your risk for stroke.
• Very high blood pressure. Very high blood pressure that comes on suddenly is dangerous. It is a medical emergency.

Other causes of a hemorrhagic stroke are anticoagulant and antiplatelet medicines. These medicines can cause bleeding in the brain. These medicines, also called blood thinners, increase the time it takes for a blood clot to form.

When you have a hemorrhagic (say "heh-muh-RA-jick") stroke, it means that a blood vessel in the brain has burst open or has started to leak. When the blood spills into the space inside and around the brain, it damages nearby nerve cells.

This is different from an ischemic (say "iss-KEE-mick") stroke, which happens when a blood clot blocks a blood vessel in the brain.

The brain damage from a stroke starts within minutes. The part of the body controlled by the damaged area of the brain cannot work properly. Quick treatment can help limit damage to the brain and make recovery more likely.

The problems someone has after a stroke depend on what part of the brain was affected and how much damage the stroke caused. A stroke may affect movement and senses, speech, memory, thinking, or emotions. Stroke rehabilitation, which includes training and therapy, can help people recover.