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Can anxiety cause mini strokes?

Hemorrhagic Stroke

Doctor looking at clipboard

Doctor looking at clipboard

A stroke that leads to hemorrhage (too much blood in the brain) is called a hemorrhagic stroke. If you have a hemorrhagic stroke caused by a slow accumulation of blood, you may experience symptoms such as headaches, lethargy, and nausea or vomiting.

Your chances of experiencing a hemorrhagic stroke are higher if you are older (over age 65), have a family or personal history of stroke, have uncontrolled diabetes, high cholesterol, or high blood pressure, smoke, are obese, do not exercise, or have a poor diet.

Hemorrhagic strokes that result from a rupturing blood vessel can have serious, immediate, and life-threatening symptoms such as:

  • Sudden, severe headache near the back of the head. Many people have described this as the “worst headache of your life.”
  • Losing consciousness
  • Inability to move or feel
  • Confusion and irritability
  • Muscle pain in neck and shoulders
  • Nausea and vomiting
  • Sensitivity to light
  • Seizure
  • Vision problems
  • Drooping eyelids
  • One eye pupil larger than the other

Treatment Options

We treat hemorrhagic stroke by locating the source of the bleed and surgically “clipping” it, draining the skull to decrease pressure in the brain, blocking off any sources of bleeding, and/or performing minimally invasive “burr hole” removal of the intracerebral hemorrhage.

After we perform a procedure, we typically give you medications to reduce blood pressure, pain, anxiety, headaches, and/or seizures.

Vagus Nerve Stimulation for Stroke Rehabilitation

After experiencing a stroke, many survivors continue to suffer from persistent impaired upper limb function and weakness. Vagus Nerve Stimulation (VNS) electrical pulses release neuromodulators in the brain that create or strengthen neural connections to enhance the relevance of physical therapy and improve upper limb function. “Pairing VNS with rehabilitation helps stroke survivors regain their independence and improve their quality of life, months or even years after suffering from a stroke,” says cerebrovascular neurosurgeon Christopher Kellner, MD Co-Founder of the Enhanced Stroke Recovery Program. More information about paired vagus nerve stimulation for stroke rehabilitation.

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In the News

Learn more about our impact on innovative research to improve patient care

Feeling stressed? Research shows how stress can lead to heart attacks and stroke

Amygdala region of the brain

Feeling constantly stressed could increase your risk of heart and circulatory disease, according to news coverage. But is there truth behind the headlines?

Feeling stressed all the time could raise your risk of heart attack and stroke, according to a new study.

The research, which is published in The Lancet, which has received widespread media coverage, claims to show for the first time how stress could be linked to heart and circulatory disease in humans.

Constant stress has been linked to higher activity in an area of the brain linked to processing emotions, and an increased likelihood of developing heart and circulatory disease.

The researchers, from Harvard University, suggested stress could be as important a risk factor as smoking or high blood pressure.

The research was made up of two studies. The larger study, made up of 293 people, looked at their brain scans, and suggested that when you are stressed, your amygdala (an area of the brain that deals with stress) signals to the bone marrow to produce extra white blood cells.

This in turn causes the arteries to become inflamed. We already know that inflammation is involved in the process that leads to heart attacks, angina and strokes.

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When you experience stress, the amygdala sends a distress signal to your hypothalamus, which then communicates this to the rest of your body so it is ready to fight or for flight.

This could lead to ensuring that patients who are at risk are routinely screened and that their stress is managed effectively

In the first (larger) study, the researchers found that the link between activity in the amygdala and later heart events and stroke was due to increased bone-marrow activity and arterial inflammation.

The second (smaller) study looked specifically at inflammation of the arteries and activity in the amygdala in highly stressed people, and again found an association between raised amygdalar activity and more arterial inflammation. People who rated themselves as more stressed were also more likely to have higher levels of activity in the amygdala.

These processes had been previously shown in mice, but never before in humans, the researchers said.

The BHF view

Emily Reeve, Senior Cardiac Nurse at the British Heart Foundation, said: «The link between stress and increased risk of developing heart disease has previously focused on the lifestyle habits people take up when they feel stressed such as smoking, drinking too much alcohol and overeating.

«Exploring the brain’s management of stress and discovering why it increases the risk of heart disease will allow us to develop new ways of managing chronic psychological stress.

«This could lead to ensuring that patients who are at risk are routinely screened and that their stress is managed effectively,» she said.

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The study was relatively small (293 people) Of these, 22 people experienced heart or circulatory events during follow up – so the findings are based on quite a small number of people. The larger study used previously collected data, based on participants who had been screened for other reasons, mainly cancer. Although the participants had to have been cancer-free for at least one year before their brain scans were taken, this could potentially have affected the results.

For the smaller study 13 people were chosen who had an ‘increased burden of chronic stress (i.e. history of post-traumatic stress disorder)’ the report says. However, a lot of people who feel stressed in the UK will not experience stress to at such a high level.


The story was widely covered in the Daily Mail, The Telegraph, and BBC News as well as on the Today Programme and BBC Breakfast.

Overall, the coverage was quite accurate.

The evidence was made up of two studies but some of the coverage didn’t make it clear that there were two studies, rather than one larger study.

The Telegraph’s headline ‘Scientists finally discover how stress causes heart attacks and strokes’ is misleading, as the researchers say they have established a ‘link’ between brain activity in a certain area and subsequent cardiovascular disease, not a cause and effect. This study only begins to understand this and further research is needed before any conclusions can be made.

Related Links

  • Cardiovascular heart disease
  • High blood pressure
  • Stress
  • Mental health
  • Meditation, mindfulness, and heart disease
  • How to develop resilience
  • 7 ways to find happiness when times are tough
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