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Hemorrhagic strokes occur when a weakened blood vessel ruptures. The two types of weakened blood vessels that usually cause hemorrhagic stroke are aneurysms (a ballooning of a weakened region of a blood vessel) and arteriovenous malformations (a cluster of abnormally formed blood vessels also referred to as AVMs). The most common cause of hemorrhagic stroke is uncontrolled high blood pressure.
Of the 20% of strokes which are hemorrhagic; 10% are intracerebral and 10% are subarachnoid hemorrhagic strokes.
Hemorrhagic strokes, in general, tend to worsen over time. The accumulation of blood in the closed space of the skull leads to increased pressure within the brain. The rising pressure further compromises blood flow and results in further damage to brain cells. Notably, some ischemic strokes can result in rebleeding, which occurs in 7%‐23% of patients. The term for this is hemorrhagic transformation which is especially common after thrombolytic therapy. Additional stroke symptoms may occur, depending on the location and degree of hemorrhage.
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