Stroke is categorized into three types: Cerebral Infarction (vessel blockage), Intracerebral Hemorrhage (vessel rupture), and Subarachnoid Hemorrhage (aneurysm rupture). Each has a completely different onset mechanism, typical symptoms, and a distinct “golden hour” for treatment. Intracerebral Hemorrhage and Subarachnoid Hemorrhage, which involve sudden, dramatic symptoms, are particularly associated with high mortality rates.
Differences Between Ischemic Stroke, Intracerebral Hemorrhage, and Subarachnoid Hemorrhage
A simple comparison of the differences between Cerebral Infarction, Intracerebral Hemorrhage, and Subarachnoid Hemorrhage is summarized in the table below!
| Feature | Cerebral Infarction (Ischemic Stroke) | Intracerebral Hemorrhage | Subarachnoid Hemorrhage (SAH) |
| Proportion (Japan) | Approx. 70–75% | Approx. 15–20% | Approx. 5–10% |
| What is Happening? | Blood vessel in the brain gets clogged. | Blood vessel inside the brain ruptures. | Blood vessel (aneurysm) on the brain’s surface suddenly bursts. |
| Main Cause | Atherosclerosis, Atrial Fibrillation, Hypertension | High Blood Pressure (90% or more!) | Aneurysm (Congenital + Age-related) |
| Typical Onset Scene | Waking up in the morning with one-sided paralysis. | During active hours (even while straining on the toilet!). | Sudden onset with no warning whatsoever. |
| Main Symptom | One-sided paralysis, numbness, slurred speech. | Severe headache + nausea + one-sided paralysis. | The worst headache ever: “Hit by a bat” or “Struck by lightning.” |
| Headache Intensity? | Rarely strong. | Strong (over half of cases). | Ultra-Strong (over 90% of cases). |
| Consciousness? | Usually maintained. | Many quickly become dazed/sluggish. | Over half lose consciousness immediately. |
| BP at Onset | Normal to slightly high. | Extremely high (often over 200). | High. |
| Treatment Golden Time | Within 4.5 hours (t-PA) ∼24 hours(Thrombectomy). | Lowering BP in the ultra-early phase (Surgery depends on the case). | Surgery to prevent re-bleeding (The first 72 hours are critical). |
| Recurrence Prevention Meds | Antiplatelet drugs (Aspirin, etc.) or Anticoagulants. | Blood pressure medication is the most important. | Surgery (Coiling or Clipping). |
| Mortality Rate (within 30 days) | Approx. 5–15% | Approx. 30–50% | Approx. 30–50% (Half die before reaching the hospital). |
| Keyword Image | “Clogging = Clogged water pipe.” | “Rupturing = Burst hose.” | “Bulge Bursting = Balloon popping!” |
In Ultra-Simple Terms
- Cerebral Infarction → The brain vessel “is clogged by garbage.”
- Intracerebral Hemorrhage → The brain vessel “is ruptured by high blood pressure.”
- Subarachnoid Hemorrhage → The “bulge” on the brain’s surface suddenly bursts.
