Hemorrhagic Stroke – Causes, Symptoms, Diagnosis, And Treatment
What is a hemorrhagic stroke?
A hemorrhagic stroke is either a brain aneurysm rupture or a weakened blood vessel causing bleeding inside the brain. When this condition happens, blood leaks into or around the brain and causes swelling and pressure. Within minutes, brain cells begin to die.
There are two types of hemorrhagic stroke. One is intracerebral stroke and the other is a subarachnoid stroke. Intracerebral stroke is the most common type of hemorrhagic stroke. This occurs when a blood vessel in the brain bursts and leaks blood into the brain tissue. A subarachnoid stroke occurs when an aneurysm breaks open and leaks blood into the space surrounding the brain.
What causes a hemorrhagic stroke?
A hemorrhagic stroke occurs when a blood vessel in part of the brain becomes weak and breaks open. This causes blood to leak into the brain. Some people have defects in the blood vessels of the brain that make this more likely. These defects may include:
- An aneurysm
- Arteriovenous malformation (AVM)
Hemorrhagic strokes may also occur in people who are taking blood thinners, such as warfarin (Coumadin). Very high blood pressure may cause blood vessels to burst, leading to hemorrhagic stroke.
An ischemic stroke can develop bleeding and become a hemorrhagic stroke.
What are the symptoms of a hemorrhagic stroke?
Symptoms of a hemorrhagic stroke depend on which part of the brain is damaged. Most of the time, symptoms develop suddenly and without warning. But symptoms may occur on and off for the first day or two. Symptoms are usually most severe when the stroke first happens, but they may slowly get worse.
A headache may occur if the stroke is caused by bleeding in the brain. A headache may:
- Start suddenly and may be severe
- Maybe worse when you are lying flat
- Wake you up from sleep
- Get worse when you change positions or when you bend, strain, or a cough
Other symptoms occur depending on the severity of the stroke is, and what part of the brain is affected.
The following are the common symptoms:
- Change in alertness (including sleepiness, unconsciousness, and coma)
- Changes in hearing or taste
- Changes that affect touch and the ability to feel pain, pressure, or different temperatures
- Confusion or loss of memory
- Problems swallowing
- Problems writing or reading
- Dizziness or abnormal feeling of movement (vertigo)
- Eyesight problems, such as decreased vision, double vision, or total loss of vision
- Lack of control over the bladder or bowels
- Loss of balance or coordination or trouble walking
- Muscle weakness in the face, arm, or leg (usually just on one side)
- Numbness or tingling on one side of the body
- Personality, mood, or emotional changes
- Trouble speaking or understanding others who are speaking
How is a hemorrhagic stroke diagnosed?
The doctor will do a physical exam to check for problems with vision, movement, feeling, reflexes, understanding, and speaking. Your doctor may repeat this exam over time to see if your stroke is getting worse or improving.
Your doctor may do the following tests to find the type, location, and cause of the stroke and rule out other problems:
- Angiogram of the head to look for a blood vessel that is blocked or bleeding
- Magnetic resonance angiography (MRA) or CT angiography to check for abnormal blood vessels in the brain
- Cerebrospinal fluid test to check symptoms of ruptured aneurysm
How is a hemorrhagic stroke treated?
A stroke is a medical emergency. It is important to treat strokes as quickly as possible. Treatment aims to control the bleeding in the brain and reduce the pressure created by bleeding. Emergency treatment given in the hospital may include the following depending on the cause of the stroke:
- Blood thinners such as heparin, warfarin (Coumadin), aspirin, or clopidogrel (Plavix)
- Medicine to control risk factors, such as high blood pressure, diabetes, and high cholesterol
- Special procedures or surgery to relieve symptoms or prevent more strokes
- Nutrients and fluids
Post-stroke rehabilitation: Post-stroke rehabilitation can help people overcome disabilities caused by stroke damage. After the hemorrhagic stroke is brought under control with emergency care, doctors usually take other treatment measures. The goal of treatment will be to help you recover as much function as possible and prevent future strokes.
The duration of recovery and rehabilitation depends on the severity of the stroke and the extent of brain tissue damage that occurred. Different types of therapy may be involved, depending on your needs. Physical therapy, occupational therapy, speech therapy, and swallowing therapy will all begin in the hospital. If the person has severe swallowing problems, a feeding tube in the stomach (gastrostomy tube) will likely be needed.
Recovery from your stroke will begin while you are still in the hospital or at a rehabilitation center. It will continue when you go home from the hospital or center. It is important to follow up regularly with your doctor after you go home.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.