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 (266)

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I have a friend who is is the Army. His daughter lives in South Africa with her Grandmother and just had a bad fall and now has some bleeding in the brain. She is needing a surgery, but they do not have enough money for the surgery at the moment. Are there any places that help in these circumstances?

I feel your pain my mom suffered a brain hemorhage the hospital refused to operate or relieve the pressure they asked us do we want to keep her on life support or hospice I said operate and will keep her on life support they refused so left us no choice I feel like I killed her putting her in hospice they don't feed you or give you liquids do how is this natural

My father was taking couminden 'a blood thinner' at the time of his fall. He was a moderately healthy 83 year old. He fell in his back yard and hit his head (left side above his eye) on a metal tool box. He was immediately taken to the hospital emergency councious the intire time. CT scan showed a brain hemerage. Apromxetely 10 hours lator he slipped into a coma. After hearing the Drs diagnosis the family opted for him to go naterally. I found it quite odd that they didn't even have him on a saline drip, For his breathing and heart were fine til the end. Dad was a fighter, a U.S. Marine, I often wonder if the right decision was made. A week later hospis administered the potient concoction that took him from us. I say do all you can do. I Miss you Dad!😇

So sorry to hear about your brother. Life is so delicate....too many times we don't realise this. I hope your family are coming to terms with this terrible loss. My thoughts are with you xx

Yesterday Monday, October 13, 2015 I had to bring my father in this hospital. Dr. told us that he has a big blood clot inside his left side brain and getting bigger reaching for the right side of the brain. He just fell asleep with loud snoring and could not open his eyes or move his right leg and hand. Could not answer using any words but tried to shake his head. Currently under life support, what they call ventilator. His breathing rate is improving but still has no sense. And now in the icu I found my father's both legs are moving sometimes. But they are telling me that the signal to move his legs is not coming from his brain. Its just muscle movement. They refused to go any further even to think about a surgery. May be because of his age is over 70 now. And when I tried to force them to do something, they told me to pray for him and thats all what we can do... Another surgeon told me that even if they took a chance, probability of his recovery is less than 20%... Feeling ice-cold heart inside just to imagine watching him die... Anyone can suggest anything?

My nephew fell whilst out drunk in the early hours of Saturday morning, he was rushed to Hope Hospital and has had a CT scan which has shown a bleed in his brain!!! Can this bleed rectify itself or will they have to operate?? He is really suffering with headaches which are causing him tremendous pain...... Any advice will be welcome

My sister had a shunt fitted which worked too well, it removed all the fluid from around her brain. This caused her to have a large bleed. They have operated and drained the bleed but a CT scan shows the bleed has not stopped. She is also on Warfarin to stop blood clots. They have had to lower the dose until the bleed stops. What will they do next to stop the bleed? 

my wife had a aneurysm and is in a coma for about a month.

she opens her eyes and responds or commands to close her eyes .

she squeezed my hands sometimes on command.   How do I get her out of this

coma. I feel depressed and helpless about her condition .

My brother fell last Tuesday and hit the back of his head. Complained later of a headache and there was some vomiting but would not get it checked out. Thursday morning, still vomiting and had terrible headache. Seizures started at 9am, ambulance was called. He was was unresponsive and put on a respirator. He died at 12:25pm. MRI showed significant brain bleed which caused his heart to stop.


I would like to ask for an opinion. A mature man was punched several times in the head and had been to hospital.Simple exam were done and released home. Had swallowing and bruising around right hand side eye and face. He had headaches and was talking strange. Couple weeks later he had big headache, admitted to hospital and they found  bleeding on the brain. The bleeding was on the same side he was punched. Genetic test were done twice, not linked with bleed. Gentlemen does not have any medical problems nor any facts for that. I had mix opinions from the doctors so if some one can tell me is this from assault or what Thank you 

My cousin died on thursday due to having bleeding on the brain he was in a bit of a fight 5 weeks before and got knocked to the floor he started having headaches just over a week later we told him to go to the doctors but he shook it of and said he was fine do you think this could be related to him being knocked to the floor? Please i need peoples advice

Hello my husband had an accident 6 months ago he had surgey remove blood clot. SAH contision of his front lob temprol lob  also diffuse axonal injury

My brother in law has fallen 3 times resulting in ER visits, all with brain bleeds. However, this last fall was a direct hit to the back of the head, causing bleeding to the sides and the front of the brain.  A drain was placed in his skull to drain the bleeding.  He is in a medical induced coma.  The CT scans show no change.  Drs. indicate the need to wait 72 hrs. before determining brain function, etc.  Could he have permanent brain damage?  He has been an addict a huge part of his life.  The first 2 falls were attributed to alcohol. However, this 3rd one, has no explanation.  Please share your expertise and knowledge.  Thank you kindly.  MJB

My Dad is 88-yrs old and has dementia right now he's in a care home .He has to be 24/7 watched .He has fallen a lot in the last 6 to 7 yrs. The doctors have given him CT scan and there's bleeding on his brain. The plan on doing other one to see how much the bleeding is spreading or if there's more. This is really hard I'm the only who has to make all the decisions for him.

Just Pray from bottom of your heart. This is the only Medi. 

My father recently passed away, he went into hospital because he was forgetful and ended up being diagnosed with delirium... After weeks in hospital with slight improvement every day he ended up having a clot in his lungs which they say was due to staying in the bed for too long. After 5 weeks he ended up having a brain bleed from the thinners used for the clot and this left him in a vegative state. His food and water were taken out and was left to die...he died after 9 days...devastated... He was such a strong man, I still don't understand how this all happened and really didn't get many answers from Dr's. Heartbreaking to see my father slowly die from what??.... Dehydration??!!!

Do little bleeds need surgery?

Not all brain bleeds end in severe mental illnesses or death. When I was born I had a brain bleed behind my eye. I had to receive a special treatment that opened my pupil so that they could see behind my eye. I am now 12 years old. I'm fine. 

My cousin just passed away he was only 12 years old boy He had an accident with head injures and internal injures He died because bleeding in the brain he had the accident on friday n died on wednesday which is very sad

my friend had a brain bleed and I am worried because he is aware of people and sometimes tries to speak one word at a time, but he brother wants to stop feeding him and just let him die, it has only been three weeks and he is getting better everyday, I cannot understand how a hospital can allow this, since the man is getting better each day and he does not have a DNR.  everyone is praying for him and today he asked for water and prayers.  How can one allow this, he is even moving his legs and hands.  everyone who knows him is upset.  please pray. for all persons in this situation.  How can a doctor and a brother make such a decision when the patient is getting better daily??? very upset in California

i was admitted to the icu for 21 days with a tbi, they had to drill holes into my skull to drain the bleeding in my head... 

My nephew had a spinal tap for Meningitis and is now blacking out and has seizures and pain shooting down his left arm. The hospital released him stating was due to an event, but no major events. He is 6'6 and the doctor missed the first time. Please help my 19 year old nephew. He was fine till this happened.

Hi, I got hit by a cleaning brush stick by my sister when playing with her 2 days ago and i have been feeling some pain inside my head since midnight. Please can you tell me what is happening.

Well a teacher got hurt in a car accident and she wad. In the car with her husband and some one threw a rock over the bridge and it went threw the window and hit the lady in the head and some of her brain feld out and she went threw a lot I realy dont get what happened and I cant even picture it I realy want to know?

My father died today. still cant believe it

Well my father died from a bleeding stroke a month ago i encourage anybody with dis problem to seek help fast it can kill u..

my boyfriend had a brain surgery three weeks ago to remove the tumor he had in his brain..he was fine during these three weeks..there were no problems at all..all his scans were well..he took the plane the day before to come back to the country and the moment he landed he started to feel dizzy..the doctors told him to rest..the following day he started throwing up and fell unconscious and the doctors said he started losing blood in his brain..he has been rushed to India to get treatment but the doctors said he might not make it..Are there chances he can make it?He has been unconscious for almost two days now...and has already got to the hospital

I crashed while riding my bike in late July 2014.  Hit my head in the crash but fortunately was wearing a helmet else injury would have been worse.  Initially sought no medical help post crash but began suffering severe headaches about two weeks later.  My conditioned worsened to the point that I was suffering from stroke-like symptoms. Three weeks post crash My wife forced me to go to the ER of a nearby hospital.  A CT scan revealed a subdural hematoma.  Was transferred by ambulance to another hospital for neurosurgery.  Had two burr holes drilled through my skull to drain the blood from the  SH.  For 36 hours post-op I was flat on my back in a hospital room with a tube  coming out of each burr hole so more bold from the hematoma could be drained.  Surgery on Friday evening and released on Monday afternoon (Labor Day), feeling a lot better.  Returned to work the day after release (I'm a teacher so work is not physically strenuous).  Felt progressively better each day thereafter.  Cannot ride a bike for four months but I can walk and hike and ride stationary bike for exercise.  There is a lot of hope for subdural hematoma sufferers.

My sister now had a stroke and when she fell from the stroke she hit her head and now on that side of the brain she is bleeding from the fall, so now she had another stroke while in the hospital because they said they can't treat her stroke because of the bleeding on the other side. My question is there anything else they can do?

My uncle has this, but he won't be going through surgery. Any reason why. He was given meds.

Ask about nuycenta er, its a time released pain killer.

Hello, I feel sorry for every human being , that suffers from any type of pains. my son had an accident on June 8 and had brain surgery on his right back next to the ear. Can someone tell me what doctor can help us to minimize his headaches, all body is in pain. They give him norco 20 mg and neurontin which doesnt help. Please we leave in LA, if someone can help me with advise.

Sincerely marine   msarib2004@yahoo.com

I will pray for everyone and wish you quick recovery

Does this explanation apply to Cerebral Palsy?

My step dad and I were home alone I was 5.  He went to shovel to roof fell off and came in the house with blood coming out of his ears, nose and mouth, i think i went to the neighbors house and they called the hospital and they had him their quickly but he passed.   All this time latter i know have seizures due to epilepsy and sometimes fall, it is scary, some times i don't even have my head checked out, oh well

My sister had an aneurisn on Father's Day of 2013. She is a miracle in all of her family's eyes. I cried cause she is so strong and such a survivor too. She also lost her husband to cancer shortly thereafter. I am just so proud of her, she recently got her license. She was soo thrilled. I was wondering if the headaches that she has will ever go away or is it going to stay with her for the rest of her life??

Does a patient w negative CT scan and LP results showed xanthochromia, erthocytes and high protien and  shows bilateral drop foot (hours after lp) likely have hemotoma or traumatic tap?

Could u live when your brain bleeds

I slipped and fell a month ago getting in my truck. I hit the back of my head on the corner of the truck cab. I sat there and watched the car next to me go from gray to almost black. Since then I am have trouble with dizzyness. If I stay in one position for very long and move I get dizzy to the point I have to hold on to some or fall.

I dont get why some people survive and some die frome a bleed in there brain

My 26 year old little brother was attacked and beaten badly, a CT scan has shown a 7mm bleed to the left side of the brain by the left ear, the hospital have said they won't operate as it hasn't ruptured, but if it ruptures I fear he won't survive to tell the tale.
TRAUMATIC BRAIN INJURY-A CAREGIVER'S STORY I brought a child into this world. I loved and nurtured this child. I taught her right from wrong. I strongly influenced her morals and values. I guided her as I watched her grow. She grew to be a beautiful young lady with a kind, caring heart and a beautiful soul. I loved her dearly. I prayed that she had learned what I gave up my life to teach her. I allowed her to shine as I took a step back with love and pride knowing I raised her well. Then tragedy strikes and in one moment in time it is taken all away from me. They call it traumatic brain injury. She lays lifeless in a coma, hooked up to machines that are giving her life. The doctors have saved her life but can give me no answers as to what the future will be for my child, the child that I have loved so dearly and watched her grow to be the beautiful young lady that she was, with a kind, caring heart and a beautiful soul, the young lady that has been taken from me who lays lifeless in a coma. The doctors and nurses took me down a road, the rebirth of my daughter. I have watched the rebirth of this child from the moment the fingers on her left hand started to wiggle and then her left eye started to open. I didn't know it then but she was being reborn before my eyes. It now is the second time I am watching my child grow. But this time it is different from the first time as she grew from an infant. This time the unknowing and the unexpected, the hours and hours of research involved to gain knowledge and strength so I can be the best mother I can be to help my daughter on her journey. It is hard to tell you the deep feeling of love I have for this child. It is an unexplainable feeling. A feeling that unless you go through it, it would be unexpectable to feel or know. There is an overpowering feeling of love and total devotion, so much stronger now then the first time I watched her grow from birth. It is a love that circumferences every fiber of my being; a feeling of pride that can bring me to tears. Like when I heard her say ma-ma for the first time after 4 months of silence. Or when she turned her head or moved her arm or leg for the first time, or even when she learned how to swallow a bit of Italian ice for the first time. Or when she asked me with such innocence and wonderment, what is a pretzel or ma-ma what is a pear? The bewilderment I felt as she ate it having to accept that she honestly didn't know what it was. I just took for granted that she knew but she didn't know. She didn't know anything. She lived in the moment, no past, and no thoughts of the future. I needed to reteach her all about life and how her life experiences made her the person she was today. As her memory came back she was astonished about how she knew certain things about life and herself. She wonders if I am her mommy and is amazed at the miracle of life and that she was born. It is now coming up on the second anniversary of that moment in time when my daughter was reborn; watching her grow a second time brings such a fulfillment of hope and pride. It is with this overpowering feeling that I know with all the sacrifices I have made along the way to devote myself and my life to the rebirth of my daughter; being her eyes and ears when she could not speak or hear, learning how to be a great caregiver to her, and instinctively, strongly advocating for her, finding the resources that are out there to help my daughter, putting her therapies in place and watching her conquer, achieve and advance to new levels and climbing those mountains with unexplainable strength, courage and determination to overcome her deficits to the best of her abilities. I know that this is the greatest accomplishment of my life and worth every sacrifice I have made along the way and will go on making as I help my daughter continue to be the heroine of her life and not the victim. Excerpt from my journal, written September 29, 2008
I was with my brother when he passed away from a glioblastoma two years ago. He was breathing but when I turned the light on I saw blood from his nose onto his pillow and grey lines on his face. The ambulance workers worked on him for over an hour/ Can you tell me what probably happened to have him still breathing, the blood on the pillow and the lines on his face. Had he passed away when I found him or was he still alive??
My mum was admitted to icu, she thought she had a headache from dehydration within a few hours started vomiting. My dad took her to the hospital thinking that she may have heat stroke from walking around in the sun all day. On arrival to the hospital they gave her a ct scan they diagnosed her with a subdural haematoma "no accident, no fall, no bumps of the head" not one doctor can explain how or why? and we have been through the last few wks to figure out if she may have had a accident, mum is a spring chicken and very active and fit. Can someone explain how, why? Frustrated and worried daughter
my nephew had an accident on 29th may 2013, by bike colliding with bike coming from other side. when police brought him hospital and informed me of accident, he was already unconscious. after doing CT scan found bleeds in right side of brain. we rushed to guwahati GNRC hospital for surgery which took us around 9 hours to reach. after reaching he was given ventilation and operation done within 1 hour. its already been 1 month he is still unconscious,but we were given assurance that he will recover and we also hoping that he will open eye either today or tomorrow..my pray to GOD...
My niece had a stroke in her sleep and never woke up. when they got her to the hospital we were told she had blood on her brain in found out it was ITP. Its been a week and she is still comatose. She had to have two brain surgery done not to mention in the midst of all of it she had 3 stroke, 3 seizures, 3anersym had to have over 20+ blood transfusion, her lungs collapse and there now saying she have a flu. They said she wasn\'t going to make it and if she do she will be partially brain dead. Although she haven\'t woken up, We witness legs movement from both legs,(tighten up to like she trying to stretch)flinch when the doctor pinch her foot & mouth movement (cough)& murmur her mouth(like she trying to talk), eye movement,(shed tears)and when the nurses turned lights on her eyes tighten up as if its to bright. Sunday she halfway open her right eye, and we told the doctor the next day in he said No, she didn\'t when I and some of the nurses witness it just as well. She is on the ventilator however it show her breathe a little on the monitor. The doctor said its all reflex but I believe in God report in I believe he bringing her out of it. Miracle Child
My 25 year old son suffered a severe brain injury four years ago. After being in a coma for three weeks he emerged as a vegetable and didn't talk or walk for six months. That was the most difficult time in our lives. Four years later he is living independently although doesn't have a job or a relationship but things do improve. You have to remain hopeful and take each day at a time.
Have there ever been any studies done on babies born with hematomas? My oldest daughter had two fair sized ones on opposing sides of the skull, we experienced a lot of behavioural issues with her for years and years until she was dx'd with four concomittant disorders. Would the hematomas have contributed to this dx?
My heart goes out to everyone with a loved one who is in ICU, it's a dreadful time for the family. You must understand every brain injury is different, no two are the same. Talk to the consultant in charge of the person, they will be honest and straight with you. But don't loose heart! The brain takes a very long time to recover, if it can. Therapy, patience and endless love and work is required. Bless you all.
My sister was at a skate park with a friend. Her friend dared her to do down a concrete ramp on top of a wheelie bin.. So she did and she fell off. They airlifted her to a hospital hours away and they found she has a broken neck and bleeding on the brain.. But yesterday they found a second bleed! She hasn't woken up and I'm soo worried and scared :'( I don't know what to do.. Will she make it?
I was in a car accident and i was not concious when taken to the hospital. I had no physical injuries and the hospital could not understand why i would not wake up. It took three MRI"s before they spotted a drop of blood from my brain. I am now suffering with numbness on my left hand and cold feet and thighs and slurring in my speech with memory loss. It seems like it is not getting any better. Does this problem worsen as you age? The accident was 5 1/2 years ago.What happens on the long run?