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Hemorrhagic Stroke

Hemorrhagic stroke occurs when a blood vessel bursts inside the brain. 

Our team provides advanced open cranial and minimally invasive neurovascular treatment for conditions causing hemorrhagic stroke – saving lives day after day. A higher percentage of patients treated at UC San Diego Health have hemorrhagic strokes compared to patients cared for at other San Diego county hospitals. See more stroke facts and figures.

There are two categories of conditions that can cause hemorrhagic stroke: vascular lesions, and other medical problems such as high blood pressure. 

Vascular lesions that can cause strokes include:

  • Cerebral aneurysms
  • Arteriovenous malformations (AVM)
  • Dural arteriovenous fistulas (AVF)
  • Cavernous malformations (cavernoma)

Cerebral Aneurysm

A cerebral aneurysm is a weak bulging spot on the wall of a brain artery. UC San Diego Health offers advanced minimally invasive catheter-based (endovascular) methods of treatment, including flow diversion (pipeline) and cerebral aneurysm coiling for embolization. We also perform cranial surgery for clipping aneurysms and EC-IC bypass.

Arteriovenous Malformations (AVM)

Arteriovenous malformations (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, by causing bleeding (hemorrhage) into surrounding tissues, and by putting pressure on the brain or spinal cord.

Treating Arteriovenous Malformations

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

  • An endovascular treatment using catheters to deliver liquid embolic material (glue or Onyx) to the AVM so that blood no longer flows through it.
  • Craniotomy to access and resect the AVM from healthy brain tissue. We use precise neuromonitoring and imaging to guide our surgery.
  • Stereotactic radiosurgery, which delivers a 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 protective layer between the brain and skull.

Dural arteriovenous fistulas and venous sinus thrombosis can cause headaches, increased pressure in the brain, seizures and hemorrhages. Diagnosed by cerebral angiography, these complex lesions can be treated with a variety of endovascular methods at UC San Diego Health.

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. Our neurosurgical specialists may diagnose and precisely remove these lesions with state-of-the-art imaging guidance and physiologic neuromonitoring.

Medical Causes of Hemorrhagic Stroke

The most common causes of hemorrhagic stroke are underlying medical conditions that can be treated with medication. These include:
  • High blood pressure
  • Cerebral amyloid angiopathy (CAA): A neurological condition in which proteins called amyloid build up on the walls of the arteries in the brain.
  • Conditions that are treated with medications that can cause excessive bleeding, such as aspirin or warfarin.

See also ischemic stroke.