Hematoma or bleeding in the brain

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