What is a hemorrhagic stroke?

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.

What are the symptoms?

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.

What causes a hemorrhagic stroke?

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.

How is hemorrhagic stroke treated?

Emergency treatment is done to stop the bleeding and prevent damage to the brain.

• You may need surgery or a procedure to repair an aneurysm or to remove the blood that has built up inside the brain.
• You may be given medicine to stop the bleeding.
• You will be closely watched for signs of increased pressure on the brain. These signs include restlessness, confusion, trouble following commands, and headache.
• You may take medicine to manage high blood pressure and prevent other problems.

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

How can you help prevent another stroke?

• 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 or nurse advice line 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.
  • If you drink alcohol, try to drink less. Your risk of harm from alcohol is low if you have 2 drinks or less per week. Work with your doctor to find what is right for you.
  • 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, influenza (flu), and pneumonia.
• If you think you may have a problem with alcohol or drug use, talk to your doctor.