Table of ContentsView AllTable of ContentsTypesSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Diagnosis
Treatment
A brain bleed is the second most common cause ofstrokenext to blood vessel obstruction (cerebral ischemia). Symptoms include head pain, vision changes, and weakness on one side of the body. A brain bleed is diagnosed with imaging tests and may require surgery to stop the bleeding and relieve pressure on the brain.
This article describes the symptoms and causes of a brain bleed, including how a hemorrhage in the brain is diagnosed and treated.
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Type of Brain Bleeds
A brain bleed (hemorrhage) can involve any artery or vein in the brain. Arteries are the blood vessels that bring oxygen and nutrients to tissues, while veins take carbon dioxide and waste from tissues to be eliminated. Depending on the size and location of the blood vessel, a brain bleed can range in severity from mild to life-threatening.
Brain bleeds can be described in different ways based on their location and characteristics:
Intracerebral Hemorrhage
There are two broad categories of hemorrhage:
Intracranial Hemorrhage
Intracranial hemorrhage is a general term that describes bleeding anywhere between the brain and the skull. The formation of a hematoma here places extreme external pressure on the brain.
There are four main types of intracranial hemorrhages:
Brain Bleed Symptoms
Symptoms may include:
A brain bleed may cause symptoms that rapidly worsen over the course of hours or days. Typically, the effects of a brain bleed are severe. However, many symptoms are non-specific and may not be immediately recognized as a brain problem until other, more obvious signs develop.
Are Brain Bleeds and Stroke the Same?A brain bleed can lead to a type of stroke, called ahemorrhagic stroke, in which the loss of blood to brain tissues causes brain cells to die. But not all brain bleeds cause stroke. Brain bleeds that occur between the brain and skull can lead to brain damage, sometimes severe, without causing the actual death of brain cells seen with stroke.
Are Brain Bleeds and Stroke the Same?
A brain bleed can lead to a type of stroke, called ahemorrhagic stroke, in which the loss of blood to brain tissues causes brain cells to die. But not all brain bleeds cause stroke. Brain bleeds that occur between the brain and skull can lead to brain damage, sometimes severe, without causing the actual death of brain cells seen with stroke.
Complications
A brain bleed may cause permanent damage to the affected regions of the brain, resulting in:
In some instances, amidline shiftof the brain will be identified. This is a dangerous situation in which the brain is actually shifted to one side, causing further compression on the brain.
All blood vessels can bleed, but bleeding of arteries or veins in the brain is uncommon. If it occurs, there is usually a precipitating factor.
Common causes of brain bleeds include:
Risk Factors
There are several risk factors for brain bleeds, including:
These risk factors can make you more likely to experience a brain bleed after head trauma.
Blood Vessels That Can Bleed in the Brain
Imaging tests are the primary tools for the diagnosis of a brain bleed. They can identify the location and size of a bleed as well asblood clotsand obstructions inside a blood vessel.
Brain bleeds are typically diagnosed with acomputed tomography (CT)scan. A CT scan is a technology that composites multiple X-rays to create a three-dimensional image of the brain.
In emergency situations, CT scans are generally more sensitive to acute bleeds thanmagnetic resonance imaging (MRI). With that said, MRIs (which create detailed images of soft tissues using magnetic and radio waves) are better able to detect smaller bleeds than a CT scan can sometimes miss.
Additional Testing
Other tests can help characterize the cause and nature of the bleed and direct the appropriate course of treatment.
These include:
Coma: Everything You Need to Know
There are several treatment strategies for managing a brain bleed and preventing complications. Emergency surgery may be needed. Medical care may continue for weeks after treatment.
In some cases, no treatment may be needed if a bleed is small and non-progressive. But close monitoring is necessary should the bleeding suddenly restart.
Often, rehabilitation is necessary after recovery from a brain bleed.
Surgery
Surgery is often needed for brain bleeds, particularly in emergency situations. Prior to surgery, intravenous (IV) steroids may be used to reduce swelling in the brain.
Each type of brain bleed may require a specific surgical procedure:
Medications
In addition to surgical interventions, medical management is necessary. You may need IV fluids to prevent worsening edema. Intravenoussteroidsare often needed to reduce inflammation and edema.Anticonvulsant drugsmay also be necessary to control seizures.
Rehabilitation
After the immediate treatment of a brain bleed, you may needphysical therapyorspeech therapy. Often, people recovering from a brain bleed need assistive care. You may need to re-learn things such as how to eat, speak, or walk.
If the bleed was severe, recovery can take up to a year, and many people only experience partial recovery. Rehabilitation following a brain bleed is similar to the process used for an ischemic stroke.
Benefits and Preparations for In-Home Physical Therapy
Summary
Bleeding in the brain is a serious medical emergency that can lead to disability or death. If you suspect a brain bleed, call for emergency help. Symptoms can be non-specific and may include head pain, neck pain, visual changes, weakness, slurred speech, lethargy, confusion, seizures, vomiting, and collapsing.
Treatment depends on the size and location of the brain bleed. Urgent surgery may be needed to remove a large subdural hematoma, brain tumor, or part of the skull to relieve pressure on the brain. Rehabilitation may be needed to help you relearn how to do things like eat, walk, or talk.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Society of Academic Emergency Medicine.Intracranial hemorrhage.McGurgan IJ, Ziai WC, Werring DJ, Salman RAS, Parry-Jones AR.Acute intracerebral haemorrhage: diagnosis and management.Pract Neurol.2021 Apr;21(2):128–36. doi:10.1136/practneurol-2020-002763An SJ, Kim TJ, Yoon BW.Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: an update.J Stroke. 2017 Jan;19(1):3-10. doi:10.5853/jos.2016.00864Morotti A, Goldstein JN.Diagnosis and management of acute intracerebral hemorrhage.Emerg Med Clin North Am. 2016 Nov;34(4):883-99. doi:10.1016/j.emc.2016.06.010Dhar R, Yuan K, Kulik T, et al.CSF volumetric analysis for quantification of cerebral edema after hemispheric infarction.Neurocrit Care. 2016 Jun; 24(3): 420-7. doi:10.1007/s12028-015-0204-zZhang J, Yang Y, Sun H, Xing Y.Hemorrhagic transformation after cerebral infarction: currrent concepts and challenges.Ann Transl Med.2014 Aug;2(8):81. doi:10.3978/j.issn.2305-5839.2014.08.08Pinto VL, Tadi P, Adeyinka A.Increased intracranial pressure. In: StatPearls [Internet].Greenberg SM, Charidimou A.Diagnosis of cerebral amyloid angiopathy: evolution of the Boston Criteria.Stroke.2018;49:491-7. doi:10.1161/STROKEAHA.117.016990Heit JJ, Iv M, Wintermark M.Imaging of intracranial hemorrhage.J Stroke. 2017 Jan;19(1):11-27. doi:10.5853/jos.2016.00563Yadav YR, Parihar V, Namdev H, Bajaj J.Chronic subdural hematoma.Asian J Neurosurg.2016 Oct-Dec; 11(4): 330-42. doi:10.4103/1793-5482.145102Zeng C, Tang S, Jiang Y, Xiong X, Zhou S.Seven patients diagnosed as intracranial hemorrhage combined with intracranial tumor: Case description and literature review.Int J Clin Exp Med.2015;8(10):19621-5.Takeuchi S, Wada K, Nagatani K, Otani N, Mori K.Decompressive hemicraniectomy for spontaneous intracerebral hemorrhage.Neurosurg Focus. 2013 May;34(5):E5. doi:10.3171/2013.2.FOCUS12424Saulle MR, Schambra HM.Recovery and rehabilitation after intracerebral hemorrhage.Semin Neurol. 2016 Jun;36(3):306-12. doi:10.1055/s-0036-1581995
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Society of Academic Emergency Medicine.Intracranial hemorrhage.McGurgan IJ, Ziai WC, Werring DJ, Salman RAS, Parry-Jones AR.Acute intracerebral haemorrhage: diagnosis and management.Pract Neurol.2021 Apr;21(2):128–36. doi:10.1136/practneurol-2020-002763An SJ, Kim TJ, Yoon BW.Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: an update.J Stroke. 2017 Jan;19(1):3-10. doi:10.5853/jos.2016.00864Morotti A, Goldstein JN.Diagnosis and management of acute intracerebral hemorrhage.Emerg Med Clin North Am. 2016 Nov;34(4):883-99. doi:10.1016/j.emc.2016.06.010Dhar R, Yuan K, Kulik T, et al.CSF volumetric analysis for quantification of cerebral edema after hemispheric infarction.Neurocrit Care. 2016 Jun; 24(3): 420-7. doi:10.1007/s12028-015-0204-zZhang J, Yang Y, Sun H, Xing Y.Hemorrhagic transformation after cerebral infarction: currrent concepts and challenges.Ann Transl Med.2014 Aug;2(8):81. doi:10.3978/j.issn.2305-5839.2014.08.08Pinto VL, Tadi P, Adeyinka A.Increased intracranial pressure. In: StatPearls [Internet].Greenberg SM, Charidimou A.Diagnosis of cerebral amyloid angiopathy: evolution of the Boston Criteria.Stroke.2018;49:491-7. doi:10.1161/STROKEAHA.117.016990Heit JJ, Iv M, Wintermark M.Imaging of intracranial hemorrhage.J Stroke. 2017 Jan;19(1):11-27. doi:10.5853/jos.2016.00563Yadav YR, Parihar V, Namdev H, Bajaj J.Chronic subdural hematoma.Asian J Neurosurg.2016 Oct-Dec; 11(4): 330-42. doi:10.4103/1793-5482.145102Zeng C, Tang S, Jiang Y, Xiong X, Zhou S.Seven patients diagnosed as intracranial hemorrhage combined with intracranial tumor: Case description and literature review.Int J Clin Exp Med.2015;8(10):19621-5.Takeuchi S, Wada K, Nagatani K, Otani N, Mori K.Decompressive hemicraniectomy for spontaneous intracerebral hemorrhage.Neurosurg Focus. 2013 May;34(5):E5. doi:10.3171/2013.2.FOCUS12424Saulle MR, Schambra HM.Recovery and rehabilitation after intracerebral hemorrhage.Semin Neurol. 2016 Jun;36(3):306-12. doi:10.1055/s-0036-1581995
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Society of Academic Emergency Medicine.Intracranial hemorrhage.McGurgan IJ, Ziai WC, Werring DJ, Salman RAS, Parry-Jones AR.Acute intracerebral haemorrhage: diagnosis and management.Pract Neurol.2021 Apr;21(2):128–36. doi:10.1136/practneurol-2020-002763An SJ, Kim TJ, Yoon BW.Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: an update.J Stroke. 2017 Jan;19(1):3-10. doi:10.5853/jos.2016.00864Morotti A, Goldstein JN.Diagnosis and management of acute intracerebral hemorrhage.Emerg Med Clin North Am. 2016 Nov;34(4):883-99. doi:10.1016/j.emc.2016.06.010Dhar R, Yuan K, Kulik T, et al.CSF volumetric analysis for quantification of cerebral edema after hemispheric infarction.Neurocrit Care. 2016 Jun; 24(3): 420-7. doi:10.1007/s12028-015-0204-zZhang J, Yang Y, Sun H, Xing Y.Hemorrhagic transformation after cerebral infarction: currrent concepts and challenges.Ann Transl Med.2014 Aug;2(8):81. doi:10.3978/j.issn.2305-5839.2014.08.08Pinto VL, Tadi P, Adeyinka A.Increased intracranial pressure. In: StatPearls [Internet].Greenberg SM, Charidimou A.Diagnosis of cerebral amyloid angiopathy: evolution of the Boston Criteria.Stroke.2018;49:491-7. doi:10.1161/STROKEAHA.117.016990Heit JJ, Iv M, Wintermark M.Imaging of intracranial hemorrhage.J Stroke. 2017 Jan;19(1):11-27. doi:10.5853/jos.2016.00563Yadav YR, Parihar V, Namdev H, Bajaj J.Chronic subdural hematoma.Asian J Neurosurg.2016 Oct-Dec; 11(4): 330-42. doi:10.4103/1793-5482.145102Zeng C, Tang S, Jiang Y, Xiong X, Zhou S.Seven patients diagnosed as intracranial hemorrhage combined with intracranial tumor: Case description and literature review.Int J Clin Exp Med.2015;8(10):19621-5.Takeuchi S, Wada K, Nagatani K, Otani N, Mori K.Decompressive hemicraniectomy for spontaneous intracerebral hemorrhage.Neurosurg Focus. 2013 May;34(5):E5. doi:10.3171/2013.2.FOCUS12424Saulle MR, Schambra HM.Recovery and rehabilitation after intracerebral hemorrhage.Semin Neurol. 2016 Jun;36(3):306-12. doi:10.1055/s-0036-1581995
Society of Academic Emergency Medicine.Intracranial hemorrhage.
McGurgan IJ, Ziai WC, Werring DJ, Salman RAS, Parry-Jones AR.Acute intracerebral haemorrhage: diagnosis and management.Pract Neurol.2021 Apr;21(2):128–36. doi:10.1136/practneurol-2020-002763
An SJ, Kim TJ, Yoon BW.Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: an update.J Stroke. 2017 Jan;19(1):3-10. doi:10.5853/jos.2016.00864
Morotti A, Goldstein JN.Diagnosis and management of acute intracerebral hemorrhage.Emerg Med Clin North Am. 2016 Nov;34(4):883-99. doi:10.1016/j.emc.2016.06.010
Dhar R, Yuan K, Kulik T, et al.CSF volumetric analysis for quantification of cerebral edema after hemispheric infarction.Neurocrit Care. 2016 Jun; 24(3): 420-7. doi:10.1007/s12028-015-0204-z
Zhang J, Yang Y, Sun H, Xing Y.Hemorrhagic transformation after cerebral infarction: currrent concepts and challenges.Ann Transl Med.2014 Aug;2(8):81. doi:10.3978/j.issn.2305-5839.2014.08.08
Pinto VL, Tadi P, Adeyinka A.Increased intracranial pressure. In: StatPearls [Internet].
Greenberg SM, Charidimou A.Diagnosis of cerebral amyloid angiopathy: evolution of the Boston Criteria.Stroke.2018;49:491-7. doi:10.1161/STROKEAHA.117.016990
Heit JJ, Iv M, Wintermark M.Imaging of intracranial hemorrhage.J Stroke. 2017 Jan;19(1):11-27. doi:10.5853/jos.2016.00563
Yadav YR, Parihar V, Namdev H, Bajaj J.Chronic subdural hematoma.Asian J Neurosurg.2016 Oct-Dec; 11(4): 330-42. doi:10.4103/1793-5482.145102
Zeng C, Tang S, Jiang Y, Xiong X, Zhou S.Seven patients diagnosed as intracranial hemorrhage combined with intracranial tumor: Case description and literature review.Int J Clin Exp Med.2015;8(10):19621-5.
Takeuchi S, Wada K, Nagatani K, Otani N, Mori K.Decompressive hemicraniectomy for spontaneous intracerebral hemorrhage.Neurosurg Focus. 2013 May;34(5):E5. doi:10.3171/2013.2.FOCUS12424
Saulle MR, Schambra HM.Recovery and rehabilitation after intracerebral hemorrhage.Semin Neurol. 2016 Jun;36(3):306-12. doi:10.1055/s-0036-1581995
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