The risk of a cerebrovascular accident is proportional to the degree of alcohol intoxication; heavy drinkers (more than 60 g/day for men, more than 40 g/day for women) have a higher risk. However, a recent study revealed a risk of cerebral haemorrhage independent of the amount of alcohol ingested.

There are several hypotheses about the mechanisms of action of alcohol:

• arterial hypertension induced by alcohol,
• problems with cardiac rhythm induced by alcohol,
• changes in platelet aggregation linked to alcohol.

Poor compliance with therapy for hypertension or diabetes also increases the risk of cerebrovascular accidents in alcoholic patients.