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 (244)

I'm going through the same thing right now. I would like to know what you found out?

In the same condition now. Had a serve headache like never before and had a ctscan. I was airlifted to a hospital and they are running more tests. Second day for me with an angiogram scheduled later today.

my 19 year old son was in a car accident in April of 2017 and no MRI was ever done. He had a concussion, whip lash, bulged discs and injured leg. Has suffered with much more severe migraines and odd headaches like a baseball bat hitting the back of his head. We decided to go to ER for the next bad migraine he would have to try to expediate a neurology appt that was still way off in the future. ER doc gave him Toradol injection. 8 hrs. later my son had a brain bleed and a stroke . Was told in the ER that he may have a horrible rebound migraine. We called PCP and was seen 2 days later. PCP ordered Mri, which was done 1 and half weeks later which showed brain bleed with dried blood surrounding the pons. Was admitted to ICU neuroscience unit for 4 days and released was told to live life cautiously. All the other scans could not tell where the bleed came from because of all the dried blood that was 2 weeks old (when stroke occured). He begins therapy because stroke caused weakness on his right side . They couldn't tell us much other than to have another MRI with contrast in 3 months and maybe they could have a better idea of his problem. I'm scarred if it is a recurrent bleed, which they said is possible. Has anyone ever heard of this happening from Toradol. The nurse did say he was giving him more than the usual dose because he "is a big guy". My son is 6'5 and 265 pounds.

Where do you live? Sounds like a bunch of quacks looked at your son from the day of the accident and has continued since. The biggest idiot was the Dr. who didn't give him proper care in the first place after the accident. He Never should have let him out the door without an MRI. Even a basic yahoo knows if you have a head injury what's the first thing you do? A Duh check his Head out. And since you cant see inside his head what should you do.....I tell ya its that dr. that needs his head examined, and not for injuries for stupidity! Just want to say sorry your son and you had to go through this, Its inexcusable if you ask me!

I accidentally fall on the floor and hit my head. I have laceration on my right eyebrow but it is now already treated. What I am worrying is that I have blood draining from my mouth, is this because my brain is bleeding?

My fiancé went to the hospital Monday and he didn't know he had water on the brain from him falling and passing out. Now he is in a coma but he is breathing on his own. Does this mean death or what? I'm so scared for him and myself. I hear so many stories. I'm in Virginia and he's all the way in Kentucky.

My friend was perfectly healthy until yesterday evening he felt severe headache followed by vomitting and nausea. On CT scan of head it was identified he has a blood leakage in his head. But however doctors aren't able to identify yet why and where precisely the blood is leaking. They drilled his top of the head and removed clot or liquid to ease pressure on this brain. Today they have done MRI and still they didnt reach out to us. What could be the cause? Any similar situations? He is just 29 year old and perfectly a healthy person.

My girlfriend at about lunchtime felt a massive headache followed by lots of vomiting called an ambulance to hospital ct scan MRI only to be told you have a bleed on the brain. Blood work was just taken, a heart ultrasound. Hopefully, I will still be here when the doctor brings back the result of blood works in the meantime my friend is suffering from throbbing headaches will update when I know more. regards

My son in law was 34. He was at work and went to his truck to get a band aid. Somehow he fell and hit his head. When he got to the hospital they said he had a brain bleed but they stopped it. Within a few hours they checked again and he had another bleed. He never woke up. My daughter choose to donated his organs. I just don't understand.

My 58 year old sister was experiencing headaches for two days. She started chemo a month ago and everyone thought she was finally starting to feel the impact of that medication. Unfortunately, late on the second day, she had a major brain bleed and was found on her bedroom floor, unresponsive and barely, if at all, breathing (reflexive breathing?). Her heart stopped on the way to the hospital in the ambulance. Restarted her heart, but remained unresponsive. Within hours, we had to make the decision to stop breathing for her as she was described to us as "brain dead". I asked the doctor if she was dead, and he responded by saying "Yes". She was taken to ICU and it was in that situation that we decided to stop the assisted breathing...her heart stopped beating about 30 minutes later. What a very sad experience - she was 58. Cause? Doctor believed it was a weak point in a vein that she probably had since the day she was born and it just took this many years to burst. I hope she felt nothing more than the headaches we knew about prior to her dropping to the floor on that second day. Doctor told us that she "felt no pain" since this situation probably took her immediately...he did say it was massive and severe, having pushed her brain into one side of her skull and the situation had entered her brain stem area. Sounds horrible, but I believe that she had to have gone very, very quickly. Tough and horrible situation.

My daughter 43 had a meningioma tumor removed. The dr said he had to give her 2 units of blood. She pulled through the surgery but 2 months later she is gone. She had a Brain Bleed just like your sister. She was unresponsive at home the paramedics shocked her twice her heart started beating but she was Brain Dead. It happened so quickly I don’t know if she felt anything but she was suffering from cancer and Bells Palsy. We had them pull the plug because I did not want to see her with that tube in her mouth. She died within seconds. Feb 25,2018

In so sorry about your daughter. My brother had the same type of tumor. It was removed on September 11 of last year. He was in rehab learning to walk again and was diagnosed with the brain bleed on Feb 1st. He had the surgery to repair. Was intubated for 2 weeks after. Now he doesn't talk. He can't do anything. He sleeps about 23 hours a day. I don't know what's going to happen now. I just mainly wanted to say I'm sorry about your daughter

My dad fell and hit his head..went to hospital with a minor brain bleed that seemed stable..stable enough that they released him 24 hours later..he was home from the hospital for 4 hours and then found unresponsive on couch barely breathing ..taken back to hospital only to discover bleed bled out of control and pushed brain aside declaring him brain dead ...he passed the next morning ..I really don't understand how the hospital released him so soon without doing another cats on before he left?????!!!

That's terrible, I am so sorry for your loss. We are going through something similar. I think you should take legal action against the hospital

So sorry for your loss. my youngest daughter had stroke 8/15. She was half brain dead at the hospital, fully brain dead on 18th. We pulled the plug that night They said she died of a black bleed. She was 52.

My brother 32 years , no illness history or smoking, fall in interacranial hemorrhage at 23 July , followed by Conma grade 3 in 2 hrs Drs said nothing to be done , he passed away after 8 days at intensive care

My husband was 55 years old and had the same thing happen to him on july 9th and was in a coma seemed to be doing well and had a second bleed on july 23rd 2017 and passed away, which was my birthday. I'm so sorry for your loss..

My friend only 15 had the same thing was in a coma seem to be doing fine but died a week after

My sister had emergency surgery for bleeding on the brain. She was having slight seizures. They put her on meds and her blood pressure was high. They got that lowered now too. She is also using her left arm now which she had no movement earlier. What is her prognoses ? She is leaving ICU today and going into a regular room. She fell weeks ago. No idea if she hit her head as she was alone. She is also on mega doses of OxyContin prescribed to her for years. She had issues with her left leg giving out on her and migraines in the recent past. She has very bad back issues too. Ty

My mum has recently had a few bleeds on the brain, she was put in an induced coma for 11 days, she didn't need surgery and are still trying to find the cause, she is awake and has full speech and movement, she had so many tests and scans and they can't find the cause, she has another Monday which I'm concerned about, they want to see under the bleeds, does this mean there could be a tumour

My husband fell 6 wks ago and has blood on his brain. He can feed himself now (some) but I dress him,etc etc. Any advice on getting him to bathe? I have no professional help.

I worked hellthcare with the elderly. I would recommend using a shower bench. It has a seat and the legs extend outside and inside the tub. If you don't have a shower wand then I would use a water picture. I would not use the tub itself. Too much danger of falling. With a bench he could sit on the edge and then swing his legs in the tub while scootng over. Hope this helps you. I would also recommend calling your insurance company to see if they would support help or the county .You may qualify for free help if you are low income.

My dad fell down like 3-4 weeks ago... The doctor said a vein burst in his head which made it bleed... Throughout his time in the hospital he had mixed emotional patterns.. at first he was aggressive then he could not talk... The last week, this was a Saturday he began back to talk and was completely normal, laughing and singing... We even sang Adele..however he was waiting on an MRI before they could do the surgery and he was on a very long waiting list. I thought he would be okay... then Monday morning he died. The Dr said his brain began back to bleed. IMY with all my heart dad

When I was 2 years old. I climbed on top of a grandfather clock & pulled it on top of my head & gave me a traumatic brain injury. The neurologist said I had blood on the brain from tests done. It was up to my parents opt not for me not to have surgery at such a young age & the blood just dried up. My left hand is about 85% paralyzed. After so many years that pass, is there anything that can be done at all? 

My brother is in a correctional Institution, all in one day he's had many medical issues that has happened to him from inmates hes there with ...he was hit from behind severely 2times and was un- conciense when he then woke up (in medical in this jail)he had major dizziness and blurred vision and had bleeding from his ears and still bleeds from his ears everyday since this incident occurred..but the staff members released him with sever dizziness and blurred vision my question is : Medically what should have been done for him instead of releasing him with dizziness,blurred vision, and blood from his ears(what cautions and test)?Also, does dizziness and blurred vision happen due to the bleeding from his ears?Last, how long does a person usually have to get medical attention, when they are bleeding out their ears before it gets worse and leads to death?
There's this 4th grader that I really care about that bumped his head and it started bleeding so I searched up what happens and now I'm really scared

Hi my uncle has just had a brain bleed out of no were he was on blood thinner tables for he's hart he had some sort of shock they say this made it worse I just like to know if u think he will be ok he's only 57  and very fit 

My sister-in-law was an epileptic patient since she was a child.  She is in her early 30's and has recently had a baby.  While walking down some steps she slipped and hit her head and now she is experiencing random and chronic seizures.  She went to the ER in Utica and they sent her home and my brother has been corresponding with a specialist from Cooperstown since.  Is there anything they can do for her?  Will she be okay?  Is she going to have permanent brain damage from this?  What are some of the risks or expectations we should know about?  They're baby is less than 2 weeks old and she has had such severe seizures in the past she has an ECT device implanted in her body. 

I need a brief as my brother got brain hemorrhage last Monday. He is still on a ventilator and drs. are keeping him unconcious because of high blood pressure. Today they informed us that his blood pressure is returning to normal but CT scans show bleeding in brain. Can anyone who has been through this same condition tell me what's going on with him? i can't bear this pain please help me

I had a bicycle accident two weeks ago and had bleeding on the brain. Most times the blood reabsorbs and goes away. Mine did and I am home now resting and healing.

Did you have any kind of memory loss?

I did, for many years and i still do however I'm starting to remember things better and also whenever I see something that will remind me of whatever happened at a certain situation it will cause me to remember certain things and so that's basically how I remember most stuff but I do have memory problems but not as bad as they were about 10 years ago

Prepare for the worst. My husband was in icu on a ventilator as a result of a fall off a chair and hitting his head on metal door frame. He bled into the brain. They couldn't stop the bleeding. They took him off all sedation after 10 days but he never woke up and there was no response. We had to let him go. I feel for you, but it will depend on the extent of the bleed and if the are able to stop it. In my husbands case they couldn't.

Dr. Jeffrey B.  just wanted to let you know that you & every doctor / surgeon who have made neurology your life & passion, are all angel's here on earth with out wings. Thank you.

There aren't words to adequately express how awesome you are.

My 92 year old mother hit her head three nights ago. Today she is seeing people walking around in the house who aren't there. She refuses to go to the hospital and has no other symptoms. This has never happened before.

Same thing happened to my father-in-law. We forced him to go to the hospital on day 3 after fall. A CT scan showed bleeding of the brain. We are now waiting on a consult from a neurosurgeon.

Hi Giselle, what was the outcome of your father-in-law? My Dad is in the hospital, being sent there today for bleeding on the brain. They suspect it's been bleeding for 3 days by the CTI. He just went through radiation and he has 4th stage cancer. Thanks in advance!

I was diagnosed with a brain aneurysm 3 years ago. After many tests and a short hospital stay, I still suffer from severe migraines and memory loss. I have been very lucky to have such amazing support from my family. As it was stated above ,our amazing dog Jenny plays a huge part in my recovery. We have our funny moments too, like when I briefly forget words in English and speak to my wife in German. That's always a trip. I wish a lot of love for anyone suffering from these awful conditions.

My son's Dad & I have been together for 20 years. He had a stroke while driving and had a head on collision into a phone pole. He suffered a brain bleed & frontal lobe damage. Hospitalized for a month - he contracted bacterial dbl pneumonia, then C diff from meds. Induced coma. When he woke, he was different. Before discharge his facial color looked awful. He couldn't breathe easily. He suffered pulmonary embolism (4 clots in the lungs). That was 6 years ago. He still suffers from memory loss, short and long. He forgets from minute to minute. His days can be good - our beloved dog ' Jack ' plays the most important role in his life. People learn to adjust because we have to. I've learned to be respectful and tolerant to his needs. He did not receive inpatient rehab. An occupational therapist came to us 2X week, they did word searches and crossword puzzles. Time, love and emotional support for him are still ongoing. He did come home to us, he is different but we have him. This is an ongoing journey and has changed all our lives.

my boyfriend is currently in ICU after getting stabbed in the head to the point where it reached his brain and caused it to bleed. The bleeding has stopped but the swelling is still there. From those that have experienced something like this with someone or themselves do you think he will be back to normal? when he talks hes doesn't make sense and he barely remembers anything.

My husband complained of neck pain and was vomiting. I took him to ER. He told the doctor he also had severe headache. CT scan showed blood on the brain. They did cerebral angiogram looking for aneurysm or cause of bleed. They found nothing that could cause a bleed. Doctor sent him home and he is scheduled for repeat CT scan in two weeks. He is still complaining of neck and head pain. He has never had high blood pressure. The doctor said the bleed is not active at this time.

My mom's friend fell backwards down the stairs yesterday night, luckily her kids noticed and called an ambulance, the she was taken to the hospital. They did a CT of her head and noticed her brain was bleeding down by the spine. As of now, the doctors have said the she won't live through tomorrow. I hope that she doesn't die, but if she does, I hope it's in her sleep. Rest in Piece, to one of the nicest people I know.

A similar thing happened to my mum 3 weeks ago,it was a fall and they couldn't operate because of the blood thinner medication.She slept for 25 hours then passed.She was 81 and very fit for her age.

My moms brain was bleeding and by the time she got to the hospital she went put her self into a coma and the doctors said that there was nothing they could have done? Does anyone know if that's true? They said something about her mid brain?

My father is in hospital now (3 days) with a tube to come out now because it has drained all it can from his bleed to his brain from a fall 3 days ago. He is still in a what the Dr. call a slight coma, (not induced), because he kicks and twists, but will not or CAN NOT open his eyes. Now, Dr are moving him out of ICU or CC because they can do nothing more. I don't know what to feel about this, like all hope is gone.

My father was involved in an accident and had bleeding in his brain.He was on ventilator for 22 days.The doctors told me indirectly that his chances were very low. I remember myself feeling extremely afraid, I felt sick and vomited and did not sleep for first 2 days even though I am a 22 year old guy and I thought I was pretty tough.

Its very hard to go through this experience. When he woke up he was very aggressive and used to kick and punch everyone who came close and had to be restrained. We were blessed that he made a great recovery and although he can't work anymore but I am really glad that he is with us.

When the patient recovers from an injury like this he can never be his previous self but can still be 40-70% of his former self.

My Father went to the hospital on January 13, 2017 with this same issue. He was in and out of it, he had good and bad days. Doctors said healing time will depend on him. He passed away January 25, 2017. (Tear Drops) I LOVE YOU DADDY ALWAYS & FOREVER XOXO

I had a bleed on the left side of my brain a couple of weeks before Christmas. Had bad headaches which my GP first thought was due to some new medication, then sinus infection. Eventually went for an MRI and they found blood on my brain. Was admitted to hospital that day and transferred to a neurologic unit. Had surgery the next day. When I woke I could not speak and had forgotten things like bank PIN.

All came back over the following 3 weeks and feel fine now other than occasional light head.

Was told that bleed due to taking Warfarin.

My sister fell down stairs and went to hospital. They said she had a 2mm brain bleed. This was January 6th 2017. They said it would take a couple months to heal and sent her home. She passed away January 19, 2017 in her sleep

Same thing happened to me dad ..only they released him the next day and four hours later he took a nap and never woke up...did you try to sue the hospital for releasing your sister?