A hematoma or bleeding in the brain is a serious and potentially life-threatening condition. It occurs when blood collects inside the skull, either within the brain tissue or between the brain and skull, often due to trauma, ruptured blood vessels, or medical conditions like high blood pressure or aneurysms.
Symptoms to Watch For
Symptoms can appear suddenly or gradually, depending on the bleed type and severity.
Sudden or worsening symptoms:
Severe headache (“worst headache of life”)
Loss of consciousness or confusion
Vomiting
Seizures
Weakness or numbness, especially on one side
Slurred speech
Vision problems
Loss of balance or coordination
Unequal pupils
Drowsiness or coma
Diagnosis
CT scan (immediate and most common for detecting bleeding)
MRI (more detailed, may follow CT)
Angiography (if vascular malformation or aneurysm is suspected)
Treatment Options
Depends on the type, size, and location of the bleed.
Emergency:
Surgery (craniotomy) to remove the hematoma or relieve pressure
Burr hole drainage for subdural hematomas
Clipping or coiling if an aneurysm is found
Medical:
Blood pressure control
Stopping anticoagulants or reversing them
Seizure prevention
Monitoring in ICU
Long-Term Outlook
Recovery depends on:
The size and location of the bleed
How quickly treatment is given
Patient’s age and overall health
Possible complications:
Permanent neurological deficits
Speech or memory issues
Paralysis or mobility problems
Seizures
Rebleeding
When to Suspect a Brain Bleed
Even mild head trauma, especially in the elderly or people on blood thinners (like warfarin or aspirin), can cause a slow-growing subdural hematoma over days or weeks.
If someone experiences:
Increasing confusion
Unsteadiness or frequent falls
Drowsiness or personality changes
Headache that’s worsening over time