brain-illos-mfHemorrhagic stroke is a type of stroke that occurs when their is pooling of blood anywhere within the skull.

The tissue of the brain is very sensitive to any increase of blood, fluids, pressure or damage.

Swelling can result when increased damage or other issue occurs.

The affect may incorporate the entire Brain.

Is one of the two main main categories of a Stroke.

The other category is Ischemic Stroke.

20% of all strokes are hemorrhagic in origin.

The other 80% are Ischemic Stroke which consist of a lack of oxygen.

Medications used to help treat ischemic strokes can be deadly in hemorrhagic strokes.



  • Headache
  • Fatigue
  • Nausea
  • Vomiting
  • Weakness
  • Paralysis
  • Numbness
  • Confusion
  • Lethargic
  • Anger
  • Loss or change in sensation
  • Other motor or coordination difficulties
  • Speech changes or inability
  • Loss of consciousness
  • Coma


  • Tearing or rupture of blood vessel
  • Brain Trauma  [Head injury]
  • Brain aneurysm
  • Certain medications


1.)  Intra-axial hemorrhage  [Blood inside the brain]
2.)  Extra-axial hemorrhage [Blood inside skull but outside brain]

Intra-Axial Hemorrhage

  • Bleeding into brain itself
  • Also called cerebral hemorrhage
  • Can see bleeding into ventricles
  • Very dangerous
  • Very difficult to treat

hemstrokeExtra-Axial Hemorrhage

  • Bleeding that occurs within the skull but outside the brain

Three subtypes

1.) Epidural hemorrhage
2.) Subdural hemorrhage
3.) Subarachnoid hemorrhage.

Epidural hemorrhage

  • Occurs between the skull and the dura mater [outer most meninx]
  • Result of trauma
  • May result from tear of the “middle meningeal artery”
  • Very dangerous
  • Very uncommon

Subdural hemorrhage

  • Occurs between the dura mater and the inner meningeal layer
  • Different than Epidural hemorrhage which is tear in artery
  • Typically is a tear in veins in subdural space
  • Increase in intracranial pressure is common
  • Caused by trauma
  • More common than epidural hemorrhage
  • Classic finding in shaken baby syndrome

Subarachnoid hemorrhage

  • Refers to bleeding into the area around the brain.
  • This area is between the pia mater and the arachnoid membrane.
  • Can be result of head trauma or other


Overall exam for hemorrhagic stroke are essential

Exam by a provider is essential if any concern

CT and MRI are useful and quite helpful for evaluation of the brain

Angiography can be used to find aneurysms


Evaluation in Emergency room is often necessary and essential

Stay at hospital (ICU department) is often necessary

Ventilation may be required

Medication for Hypertension

Hyper-osmotic agents

  • Mannitol
  • Glycerol
  • Hypertonic saline solutions


  • Repair of aneurysm if appropriate
  • Improvement of inter-cranial pressure
  • Removal of blood in brain
  • Removal of excess fluid
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