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Learning About a Hemorrhagic Stroke

Bleeding inside or around brain tissue

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. Quick treatment can help limit damage to the brain and make recovery more likely.

People who have had a stroke may have a hard time talking, understanding things, and making decisions. They may have to relearn daily activities, such as how to eat, bathe, and dress. How well someone recovers from a stroke depends on how quickly the person gets to the hospital, where in the brain the stroke happened, and how severe it was. Stroke rehabilitation, which includes training and therapy, also helps people recover.

What are the symptoms?

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

  • You have symptoms of a stroke. These may 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.

Call 911 if you have symptoms that seem like a stroke, even if they go away quickly. You may have had a transient ischemic attack (TIA), sometimes called a mini-stroke. A TIA is a warning that a stroke may happen soon. Getting early treatment for a TIA can help prevent a stroke.

What causes a hemorrhagic stroke?

A hemorrhagic stroke happens to blood vessels that have been weakened. The most common causes of weakened blood vessels in the brain are:

  • 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.

Anticoagulant and antiplatelet medicines can also 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 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.

Ask your doctor if a stroke rehab program is right for you. Rehab increases your chances of getting back some of the abilities you lost.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you prevent another stroke?

  • Work with your doctor to treat health problems, such as high blood pressure, that raise your chances of having another stroke.
  • 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. Smoking makes a stroke more likely.
    • Limit alcohol to 3 drinks a day for men and 2 drinks 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, and high-fibre foods.
    • Stay at a healthy weight. Lose weight if you need to.

Where can you learn more?

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