Brain hemorrhage

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at November 1, 2016
StartDiseasesBrain hemorrhage

Bleeding that occurs in or around the brain is known as a brain hemorrhage. It can be the result of an artery located in the brain bursting. This will cause bleeding within the tissue of the brain.


Definition & Facts

There are different categories of brain hemorrhages.

  • Intracranial hemorrhage. This is when bleeding occurs inside a person's skull.
  • Intracerebral or cerebral hemorrhage. This happens when there is bleeding within or around a person's brain itself.
  • Subarachnoid hemorrhage. This is a type of bleeding that occurs in the small space between a person's brain and the thin tissue that covers it.

A brain hemorrhage is categorized as a form of stroke. The bleeding that occurs during a brain hemorrhage will destroy a person's brain cells. They are responsible for over 12 percent of all strokes that occur annually.

Symptoms & Complaints

There are a number of different symptoms that could be a sign someone is experiencing a brain hemorrhage. What type of symptoms appear will depend on the severity and the location of the bleeding. How much tissue has been affected will also influence symptoms. They could occur suddenly or after a period of time. Brain hemorrhage symptoms could begin and slowly become worse, or be serious immediately after an incident.

  • Severe Headache. A person could have a sudden and very severe headache.
  • Sudden Weakness. A person may experience a tingling or paralysis in their face, legs or arms. This is an immediate concern if it occurs on only one side of their body.
  • Confusion. There is a sudden loss of understanding of what is happening around them as well as signs of delirium.
  • Swallowing. A person will struggle with any type of swallowing.
  • Lethargy. Noticeable apathy as well as sleepiness or even loss of consciousness.
  • Sickness. A person could suddenly experience severe nausea and vomiting.
  • Vision. They could struggle to see out of one or both of their eyes.
  • Speaking. A person could struggle with speaking, understanding, writing as well as reading.
  • Balance. People may lose their sense of balance, experience dizziness and have issues with their coordination.

Many of these symptoms could also be an indication of the presence of other types of medical conditions.


There are a number of different reasons a brain hemorrhage occurs. One of them is arteriovenous malformation (AVM). This is a condition caused when the blood vessels in a brain become tangled. Arteriovenous malformations are blood vessel abnormalities. This could be identified at birth but only diagnosed should symptoms of a brain hemorrhage occur.

Head injuries are the most common cause for individuals under the age of 50 experiencing a brain hemorrhage. Cerebral aneurysms as well as taking blood thinners could lead to this condition.

Smoking, as well as drug use, have also been determined to be a cause. When a person has chronic high blood pressure, they are at an increased risk for experiencing a brain hemorrhage.

There is an abnormality of the blood vessel walls known as amyloid angiopathy. This is a result of aging. This could cause small and unnoticed bleeding in the brain prior to a full brain hemorrhage. It could also result from brain tumors as well as some forms of liver disease.

Diagnosis & Tests

When someone shows signs of a brain hemorrhage, there are certain tests that can be conducted to confirm it. A physician may perform a neurological exam. The goal will be to assess a person's motor and sensory skills. The function of their cranial nerves, balance, mood, coordination, speech, vision and more will be examined. This can be done with a reflex hammer, ophthalmoscope, flashlight and more. Depending on what is determined, a specialist may be asked to perform additional tests.

A cerebral angiogram is a test designed to detect any artery obstruction or narrowing of a blood vessel located in the brain. An image of the brain can be obtained by using a computed tomography (CT) scan. A magnetic resonance imaging (MRI) test also helps a physician get a clear image of the brain. This makes it possible to identify and confirm any type bleeding in and around the brain.

An EEG is able to monitor brain activity. It can identify many types of disorders that affect the brain. Ultrasound imaging utilizes high-frequency sound waves to produce images from inside a person's body. It is able to help analyze a brain's blood flow and more.

Treatment & Therapy

When a patient has been diagnosed with a brain hemorrhage, the situation must be very carefully monitored. The initial treatment will involve stabilizing the blood pressure and breathing. It's possible a breathing assist machine could be used. This will ensure the patient's brain is getting a sufficient amount of oxygen. Should a person be unconscious, the monitoring of their blood oxygen levels, as well as heart rhythms, are also essential. It's also important to monitor the pressure inside their skull.

It's possible for a variety of different types of medications to be administered to decrease bleeding in the area of the brain where a hemorrhage occurred. This medication will also prevent the possibility of a seizure. Surgery is also an option in certain circumstances. A patient's age as well as medical condition will be taken into consideration prior to the surgery.

The location of the hemorrhage, as well as the effect of the drainage pattern, are also important factors. It could involve endoscopic drainage as well as stereotactic needle evacuation and more. A standard craniotomy could also be performed.

Prevention & Prophylaxis

One of the leading risk factors for a brain hemorrhage is high blood pressure. It is essential a person's blood pressure be under control and properly regulated. Aspirin and similar medicines are able to prevent coagulation of blood. They are helpful with individuals at a high risk of developing a brain hemorrhage. Women who are pregnant need to be carefully monitored should any of the signs appear. The condition of their blood vessels, as their bodies change, puts them at a high risk.