What Happens When a Brain Bleeds?


I've been hearing about bleeding in the brain after a TBI. Can you explain how this happens and why it's so dangerous? What exactly is a subdural hematoma?


Let's start with the basics. A hematoma is a tumor-like collection of blood, usually clotted, located outside a blood vessel. The subdural space is located between the dura mater (the outermost, toughest, and most fibrous of the three membranes covering the brain and spinal cord) and the arachnoid membrane (the middle of these three membranes). The epidural space is located on or outside the dura mater.

Now, to answer your question, a subdural hematoma (illustrated below) is basically bleeding into the space between the brain cover (dura mater) and the brain itself. More specifically, there are blood vessels running through the brain and in the spaces between the outside of the brain and the inside of the skull. During a brain injury, any of these vessels can tear and bleed. Ruptured vessels running in the subdural space — typically veins — cause subdural hematomas. Ruptured vessels running through the epidural space — typically arteries — cause epidural hematomas. Both types of bleeding take up space in the skull and in so doing squeeze down on the brain. Because arteries are under pressure, epidural hematomas leak quickly and compress the brain rapidly while subdural hematomas leak much more slowly.

Because the brain is enclosed within the rigid skull, it gets compressed by this leaking blood. With enough bleeding, the brain gets compressed so much that oxygen-rich blood is prevented from flowing into the brain tissue. This lack of oxygen causes additional brain swelling. This brain swelling, added to the blood leaking from the torn vessel, forces the brain down through the small hole at the base of the skull called the foramen magnum. The parts of the brain that come in direct contact with the bone around this opening get so compressed that they stop working. Because these brain areas control breathing and heart rate, death can result.

Getting to the hospital quickly is the best way to diagnose and treat this bleeding, which usually requires surgery to remove the blood and relieve the pressure on the brain.

Posted on BrainLine November 4, 2009. Reviewed March 27, 2019.

Comments (269)

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I was told it can take up to two years for improvements I had two bleeds in minor vessels n head and was lucky I was in hos and hubby beside me when my anerisim burst and caused a stroke I’m confusing some words six months on but DONT care I’m still hear and able to walk and talk my sis had only a stroke and because of the slight time delay with ambulance picking her up she’s paalyzed down one side I was lucky I. Hos for 4 weeks

So glad to hear you're doing well. Hopefully you continue to make progress!!!

I fell and ended up with two minor brain bleeds. The only thing I have experienced is it seems my ear is plugged. So my hearing is off. Can that happen? There is no bleeding from my ears.

same thing

My granddaughter had a brain trauma, which resulted in brain surgery. They did the surgery, but had to do a angiography because their were some small leeks. Why is this happening

I had a car crash 7 weeks ago. I was told I had a minor bleed on the brain and I was let home the next morning. I've been having headaches and ringing in my ears... is this anything to be worried about ?

I had a fall and ended up in the hospital with a brain bleed. It has been at least 6 months now - I am fine - except for headaches occasionally. Is it OK for me to take aspirin when I have a headache. Or other types of pain killers?

Don"t take aspirin it thins your blood.. You need to go see a chiropractic..anytime you have pain there is something wrong..

I've been the same pal for 14 weeks mate takes along time I had no surgery either and having ringing in the ears that will probably never go but my headaches are getting better I think most of its stress related tho and just stop googling things cause you will get worse. I lost my taste and smell but something has come back but it's worse now everything taste disgusting.

If you got the CT Scan on your head do you recall if it hurt? Like did you feel a strong sucking pain in your head or anything of that nature?

Yes! I would suggest getting in contact with your doctor and ask for a CT Scan as soon as possible. You could have a serious problem... God bless you!

I had a brain hemorrhage in 2011 Again in 2013 Now third time in 2018. I had constant pressure in my head Ear humming Difficulty concentrating at work some days. I actually would be experiencing, so my check head pain that I would throw up at work at least once a month for 2 to 3 days in a row. My vision played games in me. I work with two screen computers at work. It was okay, but some say we're just darn difficult. I insisted my doctor send me for a scan In the meantime I consulted eye doctor Optomitistsaw that in my eyes there was swelling in the optic nerve Told me to see my doctor and ask for a scan or go to emergy. Stubborn and workaholic I decided to consult doctor again and put on a waiting list for a scan. I was very lucky From March 2018 until September it went fast . Scan detected brain bleeding. The doctor pushed for MRI because it was the 3 d time in 8 years and I am only 50. Bingo small tumor found. So if you have symptoms listen to them. Do not panic or think it is cancer right away. Insisted on doing scan made my doctor understand I had no regular migeajn. It was not hormonal pretty memo pause changes, and I was not suffering fatigue, not exhaustion. Some days I was just not concentrating and my taste buds were changing, and I had lots of tiredness installing in my weekday after day. I fainted two times over three years had a concussion because I fell I the metro one year and hit my head real hard I had a blackout at work staring at my computer. Loss of balance did it for me.I do not drink n9r take drugs n9r medication except  comadin. So balance loss was another situation scaring me. I am being followed by a neurologist . I will get a second opinion if I feel the need . It is not normal hemeraging so often . I am on warfare now . When I have my massive headaches painkillers are on the menu. I pray and have faith that my message can help me or others get more help and listen to their body . We are not numbers We are human beings Get help.

My father who is 86 fell on his head was in ER and local hospital for 6 hours,,talking before he fell asleep ...and they did not operate why.?

My brother shattered his skull and at one of the best hospitals in the world they waited 4 days to do surgery. They had to make sure he was as stable as he could be They monitored a brain bleed and they needed time to figure out the best approach to repair his skull. It was the best thing to do though it was hard waiting that long.

My 94-year-old father had the same thing happen. They said because hypertension and his advanced age the surgery would kill him most certainly. Unfortunately that is why they don’t operate and somebody over 80 when they say suffer a brain bleed. I feel for you, not being able to save someone you love. I’m sorry for your loss. I’m right there with you.

I had a intracerebral hematoma but I don't understand

My mother got hemorrhagic stroke (ICH) the bleed did not stop even after five days, CT scan at sixth day shows more mid-line shift.
Just like anticoagulant is there any medication which decrease PT/INR ration so blood can clot more quickly ?

I've had several syncopy events. Three since Oct. 2017. The most recent caused rib cage trauma as I fell across a bed rail.
An MRI revealed many mini hemorraging vessels in the brain.My neuro surgeon says it seems to be from a previous head trauma. I've had 2.
I've recently had headaches and non stop ringing in my ears. I've never had days of headache before. They are rare until now. Should I be concerned?

My cousin passed away Friday with a bleed in the brain he went bed and didn’t wake up absolutely heartbroken

I am so sorry.

I was in an rtc 2 and a half month ago and the hospital says I got a bleed on the brain. Now I have started losing vision in my right eye. How is this possible now after coming out of the hospital after nine weeks?

Two weeks ago from today my grandpa had a brain hemorrhage. He was found about an hour later on the floor and was taken to the hospital by ambulance. Two weeks have passed and his brain bleed has not gotten bigger nor smaller. Why is it not trying to heal? He cannot really communicate much he just sleeps all day. Sometimes when you ask him a question and to move his foot once for yes or twice for no he will do that. The hospital has stabilized his blood pressure and all of that but he just isn’t healing. Is this normal? Is there any chance he will get better? He literally had this stroke while my grandma was having surgery to remove the rest of her ovarian cancer which was successful. Thank you.

Prayers. Apparently stress can lead to strokes. Scary huh. My father is in hospital right now as well. Sleep is the brains way of healing.

Hi how’s your grandad doing now ? My grans in the same position :(

Hi, my mum collapsed two weeks ago today with a bleed to the brain and hasn’t woke up since. The doctors have told us the bleed has stopped, but there is a blood clot now. My mum is in hospital abroad, so it’s a little different than England. They say that they can’t operate she is in intensive care No movement eyes closed. Is this normal? Please, can someone give us some advice?

Hi my mum had the same thing ,she was talking to me in the morning she was absolutely fine,then 3 hours later I got a call to say she was found on the floor.i went to the hospital to see her and the doctor said it's bad news she never woke up laid their for one week it was so heart breaking she passed away the 9th Feb 9 months ago I can't believe my mum has gone I miss her so much she was my best friend,I hope your mum pulls through lots of love to you xx

I'm sorry your family is going thru this my uncle is in the same situation and I will pray for them both

Im sry to no this. But my husband just went threw the same thing .he clasped at wk he was in icu for 2 weeks the third week he passed.. They couldn't help him.... So my prayers to u and your family

I was told after I went to the hospital after a fall and after an MRI I had brain cancer. I had a knot on my head and a broken arm. Many severe scratches and a problem seeing. All the way to the time I was put to sleep for the surgery I was told it was cancer. The Hospital sent 3 women to my room to demand I needed to see how far it had spread. I was going for brain surgery early the next morning and still alone. Decided not to make decisions about that yet. I was still trying to adjust to brain cancer news a few hours before. After the surgery, I was told it was a brain bleed by a nurse. No doctor told me this. I was shuffled out of Erlanger Hospital and sent home a day and a half later. I saw a Doctor 5 weeks later to have the stitches removed. I thanked him for saving my life and he said, " I'm not so sure I Did". That was my last Dr visit. I was told I didn't need to come back. Now that I am over the surgery. I am confused. What just happened to me and what was the rush to tell me I was dying from brain cancer? What was the Hospital doing to get me out of Erlanger Hospital so fast. Thank God for Brothers. He stayed with me a week and fed me. If I looked up I fell down. That went away pretty quickly. My short term memory was and is still bad. I just assumed I fell at home because I don't really know. I lived alone then. I just sort of woke up in the middle of going thru motions. Sort of a fog of I has big holes and an arm that doesn't work and bumping into walls but oh well. I didn't hurt. I could see sometimes but not others but no problem. I missed the couch or chair when I went to sit. The tv had a problem with it's picture going over an down off the screen but that was my tv that had a problem not me. My brother came over and had to literally call an Ambulance and I thought he was nuts and I was just fine. I will never know what happened to me. Where the blood went from the large holes in me. I lived thru an ordeal that is still frightening to me. I am confused about the missing 2 days.

My son had a stroke and 6 seizures when he was born in 2005. The doctor said it was a bump on the left side of the brain that leaked blood causing the stroke and seizures. Is it possible for the bump to still be there?

Hello Latoya
Did doctors recommend surgery to remove blood from the brain at that time? What was their advice?

Hi, I am 16 years old and have had 3 concussions in the last year. my last one was a very powerful impact on a jet ski this summer. My symptoms have been getting progressively worse to the point of dizziness and the headaches don't seem to go away as they would before after 30 minutes. I just need to know if it's possible to have some serious damage to the brain that I don't know about. Even if there is a slight chance, do you think that getting an MRI would be a good idea, or is it not possible since it's been a month since the accident and there as no major signs of something serious.

Multiple concussions can cause permanent brain damage.See a physician/neurologist with a background in concussive head injury asap.

Yes go get you a MRI!!! Immediately that is just something you don't play around with you could be bleeding in your brain. My grandfather is on hospice now he started off having bad headaches on the right side of his head come to find out he has tumors and bleeding on his brain. Please go get help your young and get it taken care of and don't wait too late. I have a 16 year old son too! Please go! You can get a CT scan but an MRI will be able to see nerves and things like that better. Take care

Please get an MRI done. My grandfather was in a car accident three months ago. Just this past week started complaining about headaches again. He had bleeding on the brain. They performed surgery. One side of brain is draining. Waiting on other to drain. Everything will work out for you!

You need a CT scan as well as an MRI. Even now. Three concussions in such a short period of time is dangerous. Look up the recent video interview of Dr. Bennet Omalu and Brett Favre, the football player for some information. My teenager just had a concussion and the CT scan detected a previous brain bleed we never knew about. It left a stain called hemosiderin deposit. He will need to stop playing football and all contact sports for the rest of his life. Good luck 19lrath

Honestly if i was in your position i would definabtly go see a doctor to get an MRI just to be safe, i mean what could it hurt? I broke my neck about 8 years ago and i didn’t go into the doctor for 2 weeks because i had just simple pain and didn’t think anything of it. Once i eventually did see a doctor it turned out i fractured C2 and i was put in a halo. Moral of my story is, yes you should see a doctor just to be sure and so you don’t have to spend your time worrying.

My dad went to the hospital
He went in walking and talking
After that they gave him some meds had a reaction to it .
Had a bleed to his brain and now he can't speak or eat and was sent home like that would someone please tell me was that malpractice

My father went in perfectly fine for a surgery and had a brain bleed. Did they drain your fathers bleed? They refused to drain my father’s and now he has a trach and doesn’t react to us. I am wondering the same thing. I hope your father is better.

Hi All and Thank You for sharing all of your painful experiences . I, myself had a car accident almost 12 yrs ago and I was DOA when got to hospital . They say I was all already completely blue, purple, black from head to toe... Mine happened fast and I think they said i actually passed away at my apt., not sure of many details due to my family doesn't share much of it with me .... I know the nuerosurgeon said there was absolutely no hope and was waiting for my 2 other children to arrive to get with my daughter who lived close by and came to hospital, but they had to make a decision to remove me from life support ...... as that was being discussed they said a nurse in the room with me saw a finger of mine vaguely move and told doctor but he said it was reflexes...... my daughter started screaming for him to do something and he threw me in the OR and cut left skull off and stitched up my vein.... at same time he told my daughter best case sinerio would / could be that i would be a complete vegetable and he had no hopes of that at all.... he just felt - i am assuming - that i was already dead ...... well, he was in shock and the entire staff.... when i woke up some time later i was talking and knew all of my family (which is alot to know b/c such a large family and all were there) At that point he and staff called me their Miracle :) Never by my name seriously, just my miracle ..... he couldn't say anything else .... the scale ( forgot what it is named ) that tells you i suppose the condition of the brain well, mine was 3 and that is dead from what i have been told ..... i am one blessed woman ..... i was 51 yrs old when it happened and since 4 major spinal ops also but still not corrected and basically to go anyplace and walk i must go in wheelchair due to cannot walk much at all - the pain is unbarable if i do ..... i just cannot anyway b/c my body just won't work ..... there is so much detail to all of the last 12 yrs but much too much to begin to tell .... i thank GOD for saving me and the amazing nuerosurgeon who operated on me and his staff ..... but i did want to say this,,,,, i find the older or longer since the accident i tend to be getting worse and worse ..... i can barely walk out of my front door to go on porch ..... i cannot go any place that i am not so very uncomfortable in my own skin and so very many other things that i realize more and more of them getting worse ..... i would like to know if this is normal - as normal as tbi can be anyway - or what ? i must close now due to trembling which occurs with every little thing i tend to do and that is not much..... i have become so liimited last few yrs that i, at now 64 yrs of age come this November, i am concerned how much worse things will get b/c i feel i am still young and yet feel so old at same time .... always exhausted and all things get to me and my anxiety goes out of the roof and as i mentioned so very much more that henders me in life but like i say i am truly blessed to be here and then able to be so aware of so much after all of the diagnosis' given to my family ...... i hope i haven't put this down and it is near impossible to understand - that is another downfall ..... the lack of ability to communicate effectively any longer ..... feel as though ii am only existing !!!!
thank you for any help you could give and also i pray for all of you suffering from having this or those that are dealing with a loved one with it and definitely the ones whom have been loss..... so sorry to you all and GOD BLESS
Keep on Keepin' On - sort of a motto for me .....

I had a STBI years ago and was in Coma for 28 days. My brain stem were sheered and I was without vitals for 20 minutes......they resissated me and my brain swelled and I suffered Grand Mal seizures. I had a second impact syndrome within months of the first brain injury, Is it true that my brain fluid can go down my spinal cord and cause MS later on in life? I have been bullied by the medical profession that seems to think it is gunny I have cogniative issues that they can make fun or even question after I survived such a serious brain injury. Being laughed at because of my disability......Dr. F. Glynn's office and staff make fun of me and I had to learn how to do everything all over again and now I reach out to the medical profession for help and they are bulling me> Please help me and others that are being looked over and made fun of when struggling to be seen and heard... Deborah Hudson

My mom fell down stairs they sed she had a bleed on brain but they managed to sort it then next day she died why

I tripped and fell flat on my face on cement my nose was bleeding really bad my forehead and chin also hit the cement I got a headache put ice on my face. I went to the hospital later that night after the ct scan they said I had a small brain bleed they watched me for a few hours and let me come home. If I stand up or bend down or walk my head will start hurting with some small sharp jabs of pain the next day I don’t throw up but my tummy feels icky. The fall was Saturday morning and this is late Monday night and my eyes blur some.

I was thrown from my horse caused by car accellerating into him, i flew through air and my riding hat flew off too, really tight fit but strap not done up. I landed on road. Blood coming from ear and unconcious. I was in a coma with notes reading 2 and 6 on gcs. Apparently i moving around, no retina can be seen ( unsure what that could tell) and screaming. My wuestion is i am certain i recall an awareness whilst in coma of shame but only brief, apparently i had bleed on brain but not treated. Is it possible i bleed after my awareness in coma as after i woke up i really had no shame as such and lacked awareness in my behavior but was misdiagnosed for long long time so it was hard recovering. Would i have been in a vegative state? I remember nothing except this shame feeling. I could breathe but not respond to anyone except for screaming. I would be grateful for reply

My brother had a stroke and brain anurysm while driving. He hit a pole which sent him down an embankment where he hit a tree. This happened 5 months ago. The surgeons are doing a one-year study on him because of the type of aneurysm he had called bottle neck aneurysm. He is still on life support. When I talk to him he will answer me by nodding his head. Because of the trach he cannot speak but he melts words to that I understand. I asked him what color I'm wearing and he'll tell me correctly. He will joke with me and try to smile but he is paralyzed on the left side. He can wiggle his fingers and move his foot a little on the left if you ask him to.. I am there every day but he doesn't remember me being there. He developed a blood clot in his left leg which was resolved. He now has pneumonia and c-diff for the second time. Did I mention 24 years ago he had an aneurysm. This is his second one. Do people ever recover from this? I have power of attorney over him and I'm terrified to make any decisions on his life. If there's any praying people out there please pray for my brother Charles and please pray I have God's Divine Direction. Please. Be blessed...

My brother was in a motercycle accident last week. He was hit by a car. My brother had no helmet on. He is in ICU and has five brain bleeds. I am desperately trying to figure out what how his life will be if and when he wakes up. Please pray for us ours has never been a good relationship. I don't want to leave his side and my heart is broken. I wish I could tell him I love him more than the room and stars. I'm so sorry Jimmy. please come back to me.

My dad woke on Monday morning strong and did his usual routine and went back to his room to listen to the 6am news. About 6:05am my called for me and said my dad was paralyzed. We rush him to a hospital near by and they asked for CT which came back to show the was blood leak at the left side of his brain. Due to this he was declared to have suffered a stroke. He can't talk or even open his eyes. we have being searching for a neurosurgeon to help us but to no avail. may i please know any other way of keeping him till we get a specialist. Am in Ghana- West Africa. Thank you.

I had a brain bleed when I was in 8 grade due to a football accident I thought I just had a headache but went to the hospital after I kept throwing up with a migraine to find out my actual Brain was bleeding! Shortly after I had my skull cut open and theblood drained woke up with a tube in my head and my penis (catheter) I tried to rip both out and the doctor yelled at me. I still retained my memory and functions but my math skills and focus time frame went down tremendously after that , but I am blessed to still be alive and well, although numbers and reading takes me longer ever since the surgery things could be a lot worse, there is hope people have faith

Do not ignore simple symptoms and allow the doctor to fob you off with the simplest explanations. You do not have to fall to have a bleed. My symptom was simply numb fingers that the doctor said was sure to carpal tunnel syndrome! After a seizure a few days later and subsequent MRI scan it revealed a bleed on brain. Luckily the bleed was not significant impact and over a year resolved itself. The root cause was never identified despite having two angiograms. I was living an active lifestyle and eating healthy. Still have numb fingers and have to take anti-epileptic drugs.

Hi my friend fell at work 8ft down he was unconscious and bleeding from ears nose and mouth!! In the hospital they say he has a fractured skull and has a brain bleed!! The bleeding has not stopped but when he is waken up he gets really aggressive so they have him asleep for him not to pull out the tubes!! This is so sad but I would like to know what are his chances of recuperating and being ok from all his functions?