The most common sites of hemorrhagic stroke are the regions of the brain supplied by the middle cerebral artery and its branches. The primary motor cortex of the frontal lobe (Brodmann's area 4) is affected when the rupture occurs in the pre-Rolandic artery, which is one of the main branches of the middle cerebral artery. Secondary motor areas, such as the posterior part of middle frontal gyrus (Brodmann's area 6), pars opercularis (Broca's area), pars triangularis, and other areas of the pre-frontal cortex can be damaged during a stroke; these areas of the frontal lobe are supplied by the Rolandic, the lateral frontobasal, and the pre-frontal arteries. Also post-Rolandic areas of the parietal lobe and the superior temporal gyrus are also afected sometimes.
When the hemorrhage is massive, the most common sites affected are the lateral basal ganglia, such as the putamen and the claustrum, and external capsule in the base of the brain. These areas are supplied by the lateral lenticulostriate artery, which is a deep branch of the middle cerebral artery. This type of massive hemorrhage occurs in 80 % of stroke and usually leads to death.
No matter where is the exact site of the original hemorrhage, the cerebral stroke tends to spread rapidly through the cerebral cortex of one hemisphere, unless the patient receives urgent medical treatment.