Good morning. My name is Dr. Dariush Saghafi. I am a neurologist from the Cleveland, OH region of the world. Your question is an excellent one and allows us to review a few basic concepts and principles of how strokes can occur and their contributing factors. A hemorrhagic stroke is defined very simply as a stroke which occurs as the result of a blood vessel bursting and blood leaking out in a certain area of the brain which then, critically reduces blood supply and OXYGEN to a part of the brain which as a result becomes stroked. Rupture of blood vessels can occur as the result of the bursting of aneurysms or other types of vascular malformations which the patient may be entirely unaware of causing cataclysmic results of stroke and depending upon the size of the aneurysm or malformation that ruptured the severity of the stroke is determined. Blood can also spew from a ruptured vessel which is merely weakened in a certain point for some reason directly into an area of the brain where no aneurysms or malformations exist again causing the paroxysmal loss of blood and neurological function to an area of the brain. In both scenarios, usually UNCONTROLLED HYPERTENSION is the cause of the ruptures. Specifically, we believe that the predisposition to these types of strokes occurs in people who have sudden and spontaneous rises in their pressures for different reasons. I think it is possible that violent coughing could be a inciting type of event to a hemorrhagic type of stroke IF the EVENT were TIME LOCKED with the stroke. In other words, if the person suddenly started to have a spontaneous paraxoysm of coughing (which acutely raises pressure within the intracranial vault). Otherwise, if your mother simply has coughing spasms but at some point down the road has a stroke because of a bleed but that she was not really coughing at the very instant (or just before) it happened then, it would be more likely based on probability, that her stroke were due to her condition of chronic hypertension AND AGE. We must not forget that STROKES independent of cause occurs more readily based upon the natural and UNCONTROLLABLE risk factor of AGE. Therefore, coughing spasms and strokes can definitely be related when there is a clear time synchronization between the 2 events and/or it is know apriori that the patient has an intracranial aneurysm or other vascular malformation. Otherwise, hemorrhagic strokes in persons greater than 65 years of age with chronic hypertension in their history are most likely at risk for an event based upon those risk factors (hypertension and age). If you should have any other specific questions of a medical or especially of a neurological nature please feel free to look me up on this network and send me questions directly at: http://doctor.healthcaremagic.com/doctors/dr-dariush-saghafi/68474 Speedy recovery to your mother.