2007 UpToDate
Characteristics of stroke subtypes
Stroke type Clinical course Risk factors Other clues
Intracerebral hemorrhage Gradual progression during minutes or hours Risk factors include hypertension, trauma, bleeding diatheses, illicit drugs (eg, amphetamines, cocaine), vascular malformations. More common in blacks and Asians than in whites. May be precipitated by sex or other physical activity. Patient may have reduced alertness.
Subarachnoid hemorrhage Abrupt onset of sudden, severe headache. Focal brain dysfunction less common than with other types. Risk factors include illicit drugs (eg, amphetamines, cocaine), bleeding diatheses. May be precipitated by sex or other physical activity. Patient may have reduced alertness.
Ischemic (thrombotic) Stuttering progression with periods of improvement. Lacunes develop over hours or at most a few days; large artery ischemia may evolve over longer periods. Risk factors include atherosclerotic risk factors (age, smoking, diabetes mellitus, etc.). Men affected more commonly than women. May have history of TIA. May have neck bruit.
Ischemic (embolic) Sudden onset with deficit maximal at onset. Clinical findings may improve quickly. Atherosclerotic risk factors as listed above. Men affected more commonly than women. History of heart disease (valvular, atrial fibrillation, endocarditis). Can be precipitated by getting up at night to urinate, or sudden coughing or sneezing.
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