Haemorrhagic stroke, on the other hand, is caused by a rupture of a blood vessel supplying the brain, thus releasing blood into the brain. Two major subtypes of haemorrhagic stroke can be distinguished: intracerebral haemorrhage (ICH) and subarachnoid haemorrhage (SAH). The impact of alcohol on both types of haemorrhagic stroke is high. For instance, in a study conducted in Germany, more than one third of men with ganglionic ICH were alcoholics [157]. Mechanisms by which alcohol could impact on ICH and SAH include hypertension [158]. However, the risk for ICH remains elevated even when alcohol-induced hypertension has been accounted for, due to alcohol-induced vasospasm [158]. For SAH, heavy drinking occasions seem to play a specific role [158]. The vasospastic mechanism discussed for ICH may also play a role with SAH. Finally, the same mechanisms leading to a detrimental effect of heavy alcohol consumption on IHD also come into play in explaining the effect of heavy alcohol consumption on haemorrhagic stroke [156].
