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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. Blood may collect within your brain or between layers of tissue that protect the brain.

What are the signs and symptoms of a hemorrhagic stroke?

Signs and symptoms depend on which part of your brain is injured. 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 one side of your body
  • Trouble walking or communicating

What increases my risk for a hemorrhagic stroke?

  • Blood thinning medicine or a blood clotting disorder
  • Age 55 or older, or being male
  • Physical inactivity or obesity
  • High cholesterol, high blood pressure, or diabetes
  • Smoking cigarettes or using illegal drugs such as cocaine
  • A family history of stroke, or a low birthweight
  • Current pregnancy, or giving birth within the past 6 weeks

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. He will also need to know about medicines you use or illegal drugs you have taken recently. Tell him if you smoke cigarettes or drink alcohol, or if you recently had a head injury. You may also need any of the following:

  • CT or MRI pictures may show where the stroke happened and any damage to your brain. You may be given contrast liquid to help your skull and brain show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
  • An arteriography is used to take x-rays of your arteries to look for bleeding or blockage.

How is a hemorrhagic stroke treated?

  • Medicines help improve your blood's ability to clot and stop the bleeding. You may need medicine to treat high cholesterol, high blood pressure, or diabetes. You may also need medicine to decrease pain, reduce brain pressure, or prevent seizures.
  • Surgery may be needed to stop the bleeding or remove blood that has leaked out of the blood vessels. A tube may be placed in your skull. The tube drains extra fluid and checks the pressure in your brain.

What can I do to lower my risk for a hemorrhagic stroke?

  • Do not smoke cigarettes or use illegal drugs. Nicotine and other chemicals in cigarettes and cigars can cause blood vessel damage. Nicotine and illegal drugs both increase your risk for a stroke. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products. Ask your healthcare provider for information if you need help quitting.
  • Limit or do not drink alcohol. Heavy alcohol use or drinking binges increase your risk for any type of stroke. Limit alcohol to 2 drinks per day if you are a man. Limit alcohol to 1 drink per day if you are a woman. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
  • Manage health conditions. Take your medicine as directed. Check your blood pressure and blood sugar levels as directed. Keep a record and bring it to your follow-up visits. Control your blood sugar level if you have hyperglycemia or diabetes.

  • Eat a variety of healthy foods. Healthy foods include whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Eat at least 5 servings of fruits and vegetables each day. Choose foods that are low in fat, cholesterol, salt, and sugar. Eat foods that are high in potassium, such as potatoes and bananas.
  • Maintain a healthy weight. Ask your healthcare provider how much you should weigh. Ask him to help you create a weight loss plan if you are overweight. Ask about the best exercise plan for you.

What is rehabilitation (rehab)?

Rehab is an important part of treatment. A speech therapist helps you relearn or improve your ability to talk and swallow. Physical therapists can help you gain strength and build endurance. Occupational therapists teach you new ways to do daily activities, such as getting dressed. Therapy can help you improve your ability to walk or keep your balance. You may start slowly and start doing more difficult tasks over time. Your therapy may include tasks or movements you will need to do for everyday activities. An example is being able to raise or lower yourself from a chair.

What are the warning signs of a stroke?

The word F.A.S.T. can help you remember and recognize signs of a stroke:

  • F = Face: One side of the face droops.
  • A = Arms: One arm starts to drop when both arms are raised.
  • S = Speech: Speech is slurred or sounds different than usual.
  • T = Time: A person who is having a stroke needs to be seen immediately. A stroke is a medical emergency that needs immediate treatment. Some medicines and treatments work best if given within a few hours of a stroke.

Call 911 for any of the following:

  • You have any of the following signs of a stroke:
    • Numbness or drooping on one side of your face
    • Weakness in an arm or leg
    • Confusion or difficulty speaking
    • Dizziness, a severe headache, or vision loss
  • You have a seizure.
  • You feel lightheaded, short of breath, and have chest pain.
  • You cough up blood.

When should I seek immediate care?

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • You have trouble swallowing.
  • Your blood pressure or blood sugar level is higher or lower than you were told it should be.
  • You have unusual or heavy bleeding.
  • You fall.

When should I contact my healthcare provider?

  • You have trouble having a bowel movement or urinating.
  • You have questions or concerns about your condition or care.

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.

© 2016 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.

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.