Every year, millions of people around the world die from hemorrhagic stroke. Those who survive are often left with lingering symptoms such as weakness, speech and swallowing difficulties, and even dementia.
Christopher David Anderson, MD, MSc, a Mass General Brigham neurologist, answers common questions about hemorrhagic stroke symptoms and treatment. Dr. Anderson is chief of the Stroke and Cerebrovascular Diseases Center at Brigham and Women’s Hospital.
There are two kinds of strokes:
There are also two types of hemorrhagic stroke:
Both are dangerous and require prompt medical care.
Blood vessels can burst for a few reasons. They may burst due to an underlying condition like an aneurysm. Sometimes, they burst because of an abnormal tangle of blood vessels called an arteriovenous malformation (AVM). Most commonly, they burst due to weakening from long-term conditions like high blood pressure.
There are many potential signs and symptoms of a hemorrhagic stroke. Often, the symptoms come on fast. Warning signs include:
When assessing stroke symptoms, remember the acronym FAST, which stands for:
Time is critical. Act quickly if you suspect a stroke and call 911 immediately.
Every minute that passes can mean additional permanent damage to health and ability. Rarely, stroke victims may require CPR. An emergency dispatcher can coach you through the process on the phone. Note the time of symptom onset as this can be critical information for emergency responders and attending physicians.
Do not give a person with stroke symptoms any medications, including aspirin. This can potentially cause further harm, depending on the kind of stroke they are suffering. Don’t let a person with stroke symptoms drive, eat, drink, or go to sleep.
There are a variety of therapies available for patients with ischemic stroke. These therapies can remove blood clots and restore blood flow.
But hemorrhagic stroke treatment options are limited.
When a patient with a hemorrhagic stroke arrives at the hospital, medical teams work to quickly lower their blood pressure. This limits further bleeding. They also work to reverse the effects of any blood-thinning medications.
If the hemorrhagic stroke is due to an aneurysm or blood vessel malformation, surgeons can often repair the blood vessel, so it doesn’t bleed again.
Today, treatment for hemorrhagic stroke is preventive. So far, there’s no treatment that can stop or reverse existing damage. But researchers are investigating ways to change that.
High blood pressure is the biggest risk factor for hemorrhagic stroke. Researchers at Mass General Brigham are discovering new ways to identify patients who are at a high risk of developing hemorrhagic stroke or hard-to-treat blood pressure. A variety of factors, including genetics and family health history, could play a role.
There are tiny differences in our genetic code. Each one contributes slightly to our risk of many diseases, including hemorrhagic stroke.
“If we add each of those tiny risks together, we can create something called a genetic score, which collectively tells us about the risk profile for an individual patient,” explains Dr. Anderson. “This score can identify those who are at a higher risk and who might benefit specifically from preventative treatments.”
Personalized risk information means personalized treatments. In time, doctors will know how to help patients reduce their risk of hemorrhagic stroke through better control of blood pressure. And they’ll be able to identify the other unique factors that put people at risk.