Brain hemorrhage

Bleeding in the brain (also called an intracranial hemorrhage or brain bleed) is what it's called when you have bleeding in and around the brain. Bleeding can happen between the brain tissue and the skull or within the brain tissue itself. A brain hemorrhage prevents oxygen from getting to the brain. It’s life-threatening and requires emergency care.

Call 911 immediately if you have symptoms of a brain bleed.

What is a brain hemorrhage?

Your brain depends on blood vessels to deliver oxygen and nutrients. When a brain hemorrhage occurs, it cuts off oxygen to the brain and leaks blood into the area between the skull and your brain.

The bleeding accumulates in puddles within your skull and causes pressure, which prevents oxygen from reaching brain tissues.

Common causes of brain bleeds are falls or trauma to the skull from an injury. People with unmanaged high blood pressure are also at risk of brain hemorrhages.

Symptoms of brain hemorrhage

Symptoms may develop over time or immediately after a head injury. As symptoms progress over time, pressure on your brain is more severe. Some brain hemorrhage symptoms you may experience include:

• Sudden or severe headache
• Weakness, tingling or numbness in the arms or legs (often on one side)
• Nausea or vomiting
• Dizziness
• Confusion
• Difficulty speaking or understanding speech
• Loss of movement on the side of the body opposite of the head injury

More severe symptoms may occur as blood fills your brain or the area between your skull and brain. These include:

• Seizures
• Loss of consciousness
• Feeling tired

Causes of brain hemorrhage

A head injury from a car accident, falls, sports injuries or a bicycle accident is the most common cause of an intracranial hemorrhage.

If you are taking blood thinners or aspirin, a mild head injury can cause a brain bleed. This is especially true in older adults.

Other common reasons for a brain hemorrhage are:

• Brain tumors
• Cardiovascular conditions
• Untreated hypertension (high blood pressure)
• Stroke

Brain hemorrhage diagnosis

It’s important to meet with your doctor on a regular basis to evaluate lifestyle and genetic factors that may contribute to a risk of brain bleed.

To make a brain hemorrhage diagnosis, your provider will ask about your brain bleed symptoms and do a physical exam. If your doctor suspects a brain bleed is the cause of your symptoms, they will order a CT scan, an MRI or one of the following tests to locate the bleed:

• Angiogram: During an angiogram, a catheter is inserted into an artery and threaded through the circulatory system up to the brain. A dye is then injected through the catheter to make blood flow easier to see on X-rays.
• Computed tomography angiography (CTA): During a CTA test, dye is injected directly into the bloodstream to make it easy to see the arteries in your brain on a CT scan.
• Cerebrospinal fluid exam: Evidence of blood in this fluid may indicate bleeding.
• A lumbar puncture: Also known as a spinal tap, a lumbar puncture is another way to make a brain bleed diagnosis.

Intracranial hemorrhage treatment options

Treatments depend on the size of the bleed, the location in the brain and the amount of swelling. Getting prompt treatment improves the chances of recovery.

Brain hemorrhage treatments may include:

• Surgery: In some cases, traditional surgery may be needed to drain blood from the brain or to repair damaged blood vessels.
• Draining the fluid that surrounds the brain: This creates room for the hematoma to expand without damaging brain cells.
• Medication: Drugs are used to control blood pressure, seizures or headaches.
• Catheter: A long, thin tube is threaded through blood vessels until it reaches the affected area.

How long does it take to recover from a brain hemorrhage?

Rehabilitation and brain hemorrhage recovery times vary based on your situation. Part of your treatment plan may include speech therapy, occupational therapy or physical therapy. Therapy can help individuals regain brain functions (such as the ability to speak) that may have been affected by brain bleed.

Even after treatment, there is a chance you may never recover completely from a brain bleed.