Symptoms:

Stroke symptoms are typically of sudden onset and may quickly become worse. The following is a list of possible problems:

• Weakness or inability to move a body part
• Numbness or loss of sensation
• Decreased or lost vision (may be partial)
• Speech difficulties
• Inability to recognize or identify familiar things
• Sudden headache
• Vertigo (sensation of the world spinning around)
• Dizziness
• Loss of coordination
• Swallowing difficulties
• Sleepy, stuporous, lethargic, comatose, or unconscious

Signs and tests:

A neurologic exam is almost always abnormal. The patient may look drowsy and confused. An eye examination may show abnormal eye movements, and changes may be seen upon retinal examination (examination of the back of the eye with an instrument called ophthalmoscope). The patient may have abnormal reflexes. However, these findings are not specific to brain hemorrhage.

The most important test to confirm the presence of a brain hemorrhage is a CT scan, which provides pictures of the brain. A CT scan should be obtained without delay. A brain magnetic resonance imaging (MRI) scan can also be obtained later to better understand what caused the bleeding. A conventional angiography (x-ray of the arteries using dye) may be required to identify aneurysms or AVM.

Other tests may include:

• CBC
• Bleeding time
• Prothrombin/partial thromboplastin time (PT/PTT)
• CSF (cerebrospinal fluid) examination (rarely needed)