Hemorrhagic Stroke

Aneurysm treatment at UC San Diego Health System

What Is Hemorrhagic Stroke?

Hemorrhagic stroke occurs when a weakened blood vessel bursts inside the brain. While they only account for 13 percent of stroke cases, they are responsible for almost 30 percent of all stroke deaths. 

UC San Diego Health System saves lives every day with advanced open cranial and minimally invasive neurovascular treatment for conditions causing hemorrhagic stroke. Read about our stroke center’s quality and outcomes.

Types of Hemorrhagic Stroke

There are two types of hemorrhagic stroke:

  1. Intracerebral
  2. Subarachnoid

Intracerebral Hemorrhage

Intracerebral hemorrhage is the most common type of hemorrhagic stroke. It occurs when a blood vessel bursts and spills blood directly into brain tissue.

Symptoms
Symptoms typically occur suddenly and without warning, and may include partial or complete vision loss, severe headache, nausea, and/or numbess in arms, legs or face (often on just one side of the body).

Treatment
A range of surgical and medical techniques may be used, depending on the cause and severity of the stroke. Surgery is used in cases where brain cell damage is imminent.

Subarachnoid Hemorrhage

Subarachnoid hemorrhage

A subarachnoid hemorrhage occurs when blood spills into the area surrounding brain tissue. A ruptured aneurysm is typically the cause.

Symptoms
Like an intracerebral hemorrhage, there are usually no warning signs. If the hemorrhage is due to an aneurysm, you may have a headache prior to the onset of more severe symptoms. Other symptoms include nausea, stiff neck, loss of consciousness, and an intense headache.

Treatment
Our team will determine the source of bleeding, and repair either through clipping or embolization.

Causes of Hemorrhagic Stroke

Ruptured AVM

There are two categories of conditions that can cause hemorrhagic stroke, vascular lesions and underlying medical problems (e.g., high blood pressure).

High blood pressure is responsible for almost 60 percent of all hemorrhagic stroke cases. Fortunately, it is a controllable risk factor. Have your blood pressure checked regularly and speak to your doctor about your treatment options.

Other causes include:

  • Alcohol and drug use 
  • Cerebral amyloid angiopathy (CAA)
  • Conditions that are treated with medications that can cause excessive bleeding (e.g., aspirin or warfarin)

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Vascular Lesions

Vascular lesions that can lead to stroke include:

Cerebral Aneurysm

A cerebral aneurysm is a weak bulging spot on the wall of a brain artery. Approximately 3 to 5 million people in the U.S. have cerebral aneurysms (but many do not have symptoms).

We treat cerebral aneurysms with:

  • Advanced minimally invasive catheter-based (endovascular) methods
  • Flow diversion (Pipeline)
  • Cerebral aneurysm coiling for embolization
  • Clipping
  • EC-IC bypass (to restore cerebral blood flow)

Arteriovenous Malformations (AVM)

AVMs are abnormal connections between the arteries and veins in the brain that usually form before birth. AVMs can damage the brain (or spinal cord) by:

  • Reducing the amount of oxygen reaching neurological tissues
  • Causing bleeding (hemorrhage) into surrounding tissues
  • Putting pressure on the brain or spinal cord

Treatment
There are three treatment approaches for AVMs at UC San Diego that may be used in combination, depending on the size and location of an AVM:

  1. Endovascular treatment: Using catheters, liquid embolic material (glue or Onyx) is delivered to the AVM so that blood no longer flows through it.
  2. Craniotomy: Used to access and resect the AVM from healthy brain tissue. We use precise neuromonitoring and imaging to guide our surgery.
  3. Stereotactic radiosurgery: Delivers precise, high-intensity radiation to an AVM located deep in the brain tissue, eventually causing the blood vessels feeding the AVM to close off.

Dural Arteriovenous Fistula

A dural arteriovenous fistula (dAVF) or CCF (carotid cavernous fistula) is a form of AVM – an abnormal connection between arteries and veins that occurs in the dura mater of the brain. Dura mater is a thick protective layer between the brain and skull.

Dural arteriovenous fistulas and venous sinus thrombosis can cause:

  • Headaches
  • Increased pressure in the brain
  • Seizures
  • Hemorrhages

Diagnosed by cerebral angiography, these complex lesions can be treated with a variety of endovascular methods at UC San Diego.

Cavernous Malformations (Cavernomas)

Cavernomas are benign vascular lesions that can bleed or cause seizures. Cavernomas are formed from groups of tightly packed, thin-walled, small blood vessels that are filled with slow-moving or clotted blood.

Neurosurgical specialists at UC San Diego Health System may diagnose and precisely remove these lesions with state-of-the-art imaging guidance and physiologic neuro-monitoring.

For more information on the treatment of hemorrhagic stroke, contact the Stroke Center at 858-657-8530.

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858-657-8530

Stroke is a
Medical Emergency

If you have stroke symptoms, do not drive yourself to the hospital --- call 9-1-1.

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