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. |