A massive stroke is when a disruption in blood flow to part of your brain causes significant damage.

A stroke occurs when blood flow to part of your brain is interrupted. This disruption deprives your brain tissue of oxygen, causing serious consequences. Your ability to recover from a stroke depends on the severity of the stroke and how quickly you get medical attention.

A massive stroke can be fatal, as it affects large portions of the brain. But for many people who experience a stroke, recovery is long but possible.

The severity of symptoms depends on the location and size of the stroke. The symptoms of a stroke can include:

In severe cases, rigidity and coma can occur.

Strokes occur when blood flow to part of your brain is interrupted. They can be ischemic or hemorrhagic.

Ischemic stroke

Most strokes are ischemic. An ischemic stroke results from a clot that blocks blood flow to a particular region of the brain.

The clot may be a thrombosis, meaning it forms at the site of the blockage in the brain.

Alternatively, the clot may be a cerebral embolism. This means it forms elsewhere in the body and moves into the brain, leading to an embolic stroke.

Hemorrhagic stroke

A hemorrhagic stroke occurs when a blood vessel in the brain ruptures, causing blood to accumulate in the surrounding brain tissue. This causes pressure on the brain. It also causes ischemia, leaving a region of your brain deprived of blood and oxygen.

Hemorrhagic strokes typically have a higher risk of long-term complications and death than ischemic strokes.

What is the difference between a stroke and a massive stroke?

Any type of stroke can be massive, but some types may be more likely to cause more damage, including:

According to the Centers for Disease Control and Prevention (CDC), new strokes affect over 795,000 people in the United States each year. Risk factors for stroke include:

  • Age: Though strokes can occur at any age, older adults are at the greatest risk.
  • Sex: Females have a higher lifetime risk of stroke and are more likely to die from stroke.
  • Lifestyle factors: People who smoke, drink alcohol, or use illegal drugs are at a higher stroke risk. Low nutrient eating patterns and physical inactivity can also increase your risk.
  • Medications: Hormonal birth control may increase your risk of ischemic stroke. While blood thinners may decrease your risk of ischemic stroke if you have certain cardiovascular conditions, they may increase your risk of hemorrhagic stroke.
  • Family history of stroke: Researchers conducting a 2022 review of literature concluded that as many as 52% of people with ischemic stroke involved in the research may have a family history. This was compared to only 37% of those who had not had a stroke. A family history could also mean more severe strokes at a younger age, especially if you have a genetic condition that increases stroke risk.

According to the National Heart, Lung, and Blood Institute, U.S. adults who are Black, Alaska Native, American Indian, or Hispanic are more likely to have a stroke than those who are white.

Certain medical conditions can also increase your risk of stroke, including:

If a doctor suspects you’re having a stroke, they’ll perform several tests to help them make a diagnosis.

First, a doctor will conduct a physical exam and look for signs of a stroke. They’ll test your mental alertness, coordination, and balance.

If you’ve had a stroke, your doctor may also order imaging or blood tests to confirm the type of stroke you’ve had and to make sure your treatment plan aligns with your specific medical needs.

If you’re having a stroke, you need emergency care as soon as possible. The sooner you get treatment, the better your chances of survival and recovery.

Ischemic stroke

Treatment for massive ischemic strokes may involve one or more of the following:

  • clot-busting drugs within 4.5 hours to break up the blood clot
  • mechanical thrombectomy to surgically remove the blood clot within 24 hours
  • aspirin or other blood thinners to prevent further clotting
  • surgery to relieve pressure buildup in the brain (craniectomy)

Hemorrhagic stroke

If you’re having a hemorrhagic stroke, emergency caregivers may give you medications to lower your blood pressure and slow the bleeding. If you’ve been using blood thinners, they may give you drugs to counteract them.

For a massive hemorrhagic stroke, you might benefit from emergency surgery, depending on the severity of the bleeding. Doctors do this to repair the broken blood vessel and remove excess blood that may be putting pressure on the brain.

Complications and resulting impairments become more serious depending on the severity of the stroke. Complications can include the following:

Rehabilitation services can help minimize complications and may include working with:

Some people who have a stroke recover quickly and can regain regular function of their body after just a few days. For other people, recovery may take several months or longer.

No matter how long it takes you to recover from your stroke, remember recovery is a process. Trying to remain optimistic can help you cope. Celebrate all the progress you make. You may also want to consider talking with a therapist who can help you work through your recovery.

Support for caregivers

During the recovery process after a stroke, a person may need ongoing rehabilitation. Depending on the severity of the stroke, this may last for a few weeks, months, or even years.

It can be helpful for caregivers to educate themselves about strokes and the rehabilitation process. Caregivers may also benefit from joining support groups where they can meet others who are helping their own loved ones recover after a stroke.

Some good resources to find help include:

Your outlook after a stroke depends on its severity and how quickly you get medical care for it. Because massive strokes tend to affect large amounts of brain tissue, the overall outlook is typically less favorable.

Overall, the outlook is usually more favorable for people who have an ischemic stroke. Hemorrhagic strokes typically lead to more complications because of the pressure they put on the brain.

If you have had a stroke, you could be at risk of having another stroke due to underlying risk factors. Subsequent strokes are typically more severe, more challenging to treat, and more likely to lower survival rates. It’s important to take steps to reduce your stroke risk to help avoid further complications.

What is the survival rate for a massive stroke?

Many factors can influence the survival rate for strokes, including the size of the stroke, where it starts, and how soon doctors begin treatment.

In a 2019 Swedish study, about half of people who survived more than 30 days after an ischemic stroke were still alive after 5 years. Just over one-third of people who had a hemorrhagic stroke were still alive after 5 years.

Is a massive stroke painful?

Pain isn’t a typical symptom of stroke. However, some people may experience pain as part of a sudden, intense headache. There are also reports of pain that may result from effects on specific parts of the central nervous system.

What are the signs of impending death after a stroke?

When nearing the end of life after a stroke, symptoms may include increased drowsiness, refusal to eat or drink, confusion, and restlessness. You may also notice changes in the person’s breathing, including hearing the “death rattle” sound.

A massive stroke occurs when there’s a disruption in blood flow to a large portion of your brain. This can cause significant brain damage, leading to severe complications or even death.

Prompt diagnosis and treatment are essential for increasing your chances of a favorable outcome. Even with immediate treatment, recovery after a massive stroke may take months or years.