Hemorrhagic stroke

Hemorrhagic stroke accounts for approximately 10% of strokes.

Computed tomography (CT) or magnetic resonance imaging (MRI), with high sensitivity for intracerebral hemorrhage, are essential in diagnosis.

The primary treatment for people with hemorrhagic stroke involves supportive care and optimization of intracranial hemodynamics.

Surgical resection of intracerebral hematomas may be of benefit in select cases, such as cerebellar hematomas >3 cm in diameter causing brain stem compression or hydrocephalus.

Patients treated in dedicated stroke units have improved survival and reduced disability at 1 year.

Stroke is an acute neurologic deficit caused by cerebrovascular etiology. It is further subdivided into ischemic stroke and hemorrhagic stroke.

Hemorrhagic stroke is due to rupture of a cerebrospinal artery, resulting in intracerebral (intraparenchymal or intraventricular) or subarachnoid hemorrhage.

Intracerebral hemorrhage is further subdivided into primary and secondary etiology: primary spontaneous intracerebral hemorrhage is defined as hemorrhage in the absence of vascular malformations or associated diseases; secondary intracerebral hemorrhage is from an identifiable vascular malformation or as a complication of other medical or neurologic diseases that either impair coagulation or promote vascular rupture.

This topic focuses on patients with a stroke due to intracerebral hemorrhage. For information on other types of stroke, see Subarachnoid hemorrhage, Ischemic stroke, and Cavernous sinus thrombosis.