Haemorrhagic Stroke - Symptoms & Causes

What is a haemorrhagic stroke?

A haemorrhagic stroke occurs when an artery (blood vessel) in the brain ruptures and bleeds into the surrounding tissue. This bleeding causes pressure on brain cells and reduced blood flow to the normal brain tissue, leading to damage and loss of brain function.

There are two main types of haemorrhagic strokes: intracerebral haemorrhage and subarachnoid haemorrhage. An intracerebral hemorrhage happens when the artery ruptures directly in the brain tissue, while a subarachnoid hemorrhage occurs when the artery ruptures in between the inner and outer layers of tissue surrounding the brain.

Haemorrhagic stroke is less common than ischaemic stroke, which occurs due to a blockage in a blood vessel. However, it is more severe and life-threatening. Haemorrhagic strokes are often accompanied by a sudden severe headache, often termed as the ‘worst headache of my life’.

Types of haemorrhagic stroke

Haemorrhagic strokes are classified into two main types:

• Intracerebral Haemorrhage (ICH). This type of stroke happens when an artery in the brain ruptures directly within the brain tissue, flooding the surrounding tissue with blood. ICH is the most common type of haemorrhagic stroke.
• Subarachnoid Haemorrhage (SAH). This occurs when the artery ruptures in the area between the brain and the thin tissues covering it. SAH often results from the rupture of an aneurysm, a weakened area in a blood vessel wall.

What are the symptoms of a haemorrhagic stroke?

The symptoms of a haemorrhagic stroke can vary depending on the location and extent of the bleeding. Common signs include:

• Sudden severe headache, or haemorrhagic stroke headache, often described as "the worst headache of my life"
• Nausea and vomiting
• Sudden weakness or numbness in the face, arm, or leg, particularly on one side of the body
• Difficulty speaking or understanding speech
• Vision problems in one or both eyes
• Loss of balance or coordination
• Confusion or disorientation
• Seizures
• Loss of consciousness

What causes a haemorrhagic stroke?

Several factors can lead to a haemorrhagic stroke, including:

• High blood pressure (Hypertension). This can weaken blood vessel walls, making them more prone to rupture.
• Aneurysms. This condition can cause balloon-like bulges in blood vessels that can burst and cause bleeding in the brain.
• Arteriovenous Malformations (AVMs). These refer to abnormal tangles of blood vessels that can rupture and cause haemorrhage.
• Head injury. This can cause blood vessels in the brain to rupture.
• Blood thinners. Such medication can increase the risk of bleeding.
• Liver disease. Conditions like cirrhosis can affect blood clotting and increase the risk of haemorrhage.
• Cerebral amyloid angiopathy. This involves the buildup of amyloid protein in the walls of the brain's blood vessels, leading to fragility and potential rupture.

What are the complications and related diseases for a haemorrhagic stroke?

Haemorrhagic stroke can lead to numerous complications, including:

• Brain swelling (Cerebral oedema). Accumulated blood can cause the brain to swell, increasing pressure inside the skull.
• Hydrocephalus. This condition occurs when blood or cerebrospinal fluid accumulates in the brain's ventricles, leading to increased pressure.
• Vasospasm. Blood vessels can constrict in response to bleeding, reducing blood flow to the brain and causing further damage.
• Re-bleeding. The risk of additional bleeding is significant after the initial haemorrhage.
• Permanent brain damage. The pressure and damage caused by the haemorrhage can lead to long-term neurological deficits.
• Death. Haemorrhagic strokes are often fatal, especially if not treated promptly.

How do you prevent a haemorrhagic stroke?

Prevention strategies include:

• Keeping blood pressure under control through medication, diet, and lifestyle changes is crucial.
• Smoking increases the risk of stroke, including haemorrhagic stroke.
• Limiting alcohol consumption, as excessive alcohol intake can contribute to high blood pressure and other risk factors.
• Eating a balanced diet low in saturated fats and high in fruits, vegetables, and whole grains helps maintain overall health.
• Regular exercise helps control blood pressure and reduce stroke risk.
• Monitoring and treating underlying conditions such as diabetes and high cholesterol.