Hemorrhagic Stroke

What is a hemorrhagic stroke?

A hemorrhagic stroke happens when a blood vessel in your brain bursts. This may happen if the blood vessel wall is weak, or if a blood clot damages the blood vessel. Blood then flows out of the vessel and damages brain tissue.

What are the signs and symptoms of a hemorrhagic stroke?

Signs and symptoms depend on which part of your brain is injured and what damage the stroke has caused. One or more of the following may appear minutes or hours after a stroke, and worsen quickly:

  • Severe headache

  • Nausea and vomiting

  • Blurred or double vision, or vision loss

  • Dizziness, confusion, or fainting

  • Numbness, tingling, weakness, or paralysis on 1 side of your body

  • Trouble walking or communicating

How is a hemorrhagic stroke diagnosed?

Your healthcare provider will ask about your symptoms and when they started. He will ask if you have any medical conditions. The following tests help your healthcare provider know where the stroke happened, and how much damage you have:

  • CT or MRI scan: Healthcare providers use these pictures to see a burst blood vessel or bleeding in your brain. You may be given dye to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with metal. Metal can cause serious injury. Tell the healthcare provider if you have a metal implant.

  • Arteriography: X-rays are taken of your arteries to look for bleeding or blockage.

How is a hemorrhagic stroke treated?

  • Medicines: You may need medicine to improve your blood's ability to clot and stop the bleeding. You may also need medicine to treat diabetes, depression, high cholesterol, or blood pressure problems. You may need medicine to decrease the pressure in your brain, reduce pain, or prevent seizures.

  • Rehabilitation: Rehabilitation (rehab) is an important part of treatment. Physical therapists help strengthen your arms, legs, and hands. You learn exercises to improve your balance and movement to decrease your risk of falling. Occupational therapists teach you new ways to do daily activities, such as getting dressed. A speech therapist helps you relearn or improve your ability to talk and swallow.

  • Ventilator: You may need to get oxygen through a ventilator if your stroke affects your ability to breathe. A tube is put into your airway through your nose, mouth, or an incision in your neck. The ventilator gives you oxygen through the tube.

  • Surgery: You may need to have a tube placed in your skull. The tube drains extra fluid and checks the pressure in your brain. You may also need surgery to stop the bleeding or remove blood that has leaked out of the blood vessels.

What increases my risk of a hemorrhagic stroke?

  • You are taking a blood thinning medicine or have a blood clotting disorder.

  • You are at least 55 years old.

  • You are a man.

  • You are pregnant or had a baby within the past 6 weeks.

  • Your father or mother had a stroke, or you had a low birthweight.

  • You have high blood pressure, blood vessel disease, or sickle cell anemia that is not being treated.

What can I do to decrease my risk of a stroke?

  • Manage health conditions: High blood pressure, diabetes, and high cholesterol all increase your risk of stroke. Take your medicines as directed. Follow your healthcare provider's instructions to check your blood pressure and blood sugar levels. Write the numbers down to show him.

  • Eat healthy foods: What you eat can help prevent or manage high blood pressure, high cholesterol, and diabetes. Eat foods that are low in fat, cholesterol, salt, and sugar. Eat at least 5 servings of fruits and vegetables each day. Eat foods that are high in potassium, such as potatoes and bananas.

  • Reach or stay at a healthy weight: Weight loss can decrease your blood pressure and your risk of stroke. Ask your healthcare provider how much you should weigh and how to lose weight safely. Ask your healthcare provider how often you should exercise and which exercises to do. You will need to exercise carefully after a stroke so you do not fall.

  • Limit or do not drink alcohol: Alcohol thins the blood, which increases your risk of hemorrhagic stroke. Ask your healthcare provider if it is safe for you to drink alcohol. You may not be able to drink any alcohol at all. You will need to limit the amount you drink if your healthcare provider says some alcohol is safe for you. Men should limit alcohol to no more than 2 drinks per day. Women should limit alcohol to no more than 1 drink per day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

  • Do not use street drugs or smoke cigarettes: Your risk of another stroke increases if you use drugs such as cocaine, or you smoke cigarettes. Ask your healthcare provider for help if you are having trouble quitting.

What are the risks of a hemorrhagic stroke?

You may bleed more than expected during surgery. You may need a machine to help you breathe. You may have another stroke or go into a coma. You may be paralyzed on one or both sides of your body. You may not be able to care for yourself or live alone. You are at greater risk of falling. You may develop muscle shortening or bedsores. Even with treatment, you may have lasting problems talking, thinking, or moving your body. Without treatment, your risk for another stroke increases. You may die from a stroke.

How can I tell if someone is having a stroke?

Know the F.A.S.T. test to recognize the signs of a stroke:

  • F = Face: Ask the person to smile. Drooping on 1 side of the mouth or face is a sign of a stroke.

  • A = Arms: Ask the person to raise both arms. One arm that slowly comes back down or cannot be raised is a sign of a stroke.

  • S = Speech: Ask the person to repeat a simple sentence that you say first. Speech that is slurred or sounds strange is a sign of a stroke.

  • T = Time: Call 911 if you see any of these signs. This is an emergency.

When should I contact my healthcare provider?

  • Your blood pressure is higher than you were told it should be.

  • You have skin tears, or sores on your heels, head, or buttocks from lying in bed.

  • You have bowel movement problems.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You have a seizure.

  • You are bleeding from your rectum or nose.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

  • You suddenly feel dizzy, lightheaded, and have shortness of breath.

  • You have chest pain. You may have more pain when you take a deep breath or cough. You may cough up blood.

  • You have weakness or numbness in your arm, leg, or face.

  • You are confused and have problems speaking or understanding speech.

  • You have vision loss or a severe headache.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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