A hemorrhagic stroke occurs when a blood vessel
in the brain leaks or ruptures, resulting in bleeding into the brain. Parts
of the brain affected by the bleeding can become damaged, and if enough blood
accumulates, it can put pressure on the brain. The amount of hemorrhage (bleeding) determines the severity of the stroke. The other
main type of stroke is caused by blockage in the blood vessels supplying blood
to the brain and is called an ischemic stroke. The
term ischemia means inadequate blood flow, and stroke refers to the sudden onset of the symptoms. The
October 20, 2004, issue of JAMA includes an article
about detecting hemorrhagic strokes.
Hypertension (high blood
pressure) is a major risk factor for hemorrhagic strokes.
In older persons, cerebral amyloid
angiopathy (a condition that weakens blood vessels in the brain) can
lead to hemorrhagic strokes.
Aneurysms (tiny blood-filled
pouches that balloon out from weakened areas on blood vessel walls) are prone
to leaking or bursting.
Cerebral arteriovenous malformations are clumps of interconnected abnormal blood vessels that are present
from birth and can bleed later in life.
Blood vessels in brain tumors may be prone to bleeding.
Sudden numbness, weakness, or paralysis of an arm,
leg, or entire side of the body
Sudden trouble seeing in one or both eyes
Sudden difficulty speaking
Sudden confusion, dizziness, or loss of consciousness
Sudden severe headache
If you or anyone you know experiences any of these symptoms, call for
immediate emergency medical attention.
A careful medical history and physical examination of the patient are
essential. Imaging of the brain using magnetic resonance imaging or computed
tomography may be helpful to determine the type and severity of stroke. Angiography (imaging performed with contrast dye injected
into blood vessels) may be done to visualize abnormal blood vessels in the
Blood-thinning drugs used to treat ischemic stroke
should not be used in patients with hemorrhagic stroke because they can increase
If blood pressure is too high, it can be treated
Brain aneurysms may be treated with surgery.
American Heart Association 800/242-8721 http://www.americanheart.org
National Institute of Neurological Disorders and
Stroke 800/352-9424 http://www.ninds.nih.gov
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. A Patient Page on the warning signs of stroke was published in the
April 22/29, 1998, issue; one on guarding against stroke was published in
the September 23/30, 1998, issue; and one on preventing a first stroke was
published in the March 24/31, 1999, issue.
Sources: American Heart Association; National Institute of Neurological
Disorders and Stroke; National Stroke Association
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
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Parmet S, Glass TJ, Glass RM. Hemorrhagic Stroke. JAMA. 2004;292(15):1916. doi:10.1001/jama.292.15.1916