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)

Bilateral convexity subdural hematomas, larger on the left. The left subdural hematoma measures 9 mm in thickness and exerts mass effect on the adjacent brain parenchyma. The right subdural hematoma measures 3 mm. There is 2 to 3 mm of rightward midline shift. No downward herniation. The ventricular size is normal. Diffusion abnormality and susceptibility associated with blood products. this what they said about my MRI with contras, this showed up two months after my car crash, should I be worried since it happen so late after my accident? none of the other ct showed this before and I had 4 ct before this one. should I be worried

My son 30yrs ago had a very bad fracture of the skull. Over a period of years he has suffered two brain bleeds. He can’t smell anything. Now drinks to much. Is that a worry

Sir my mamiji fell from a bike. She has got severe head injury. Her surgery was done after 48 hours. In surgery, her front forehead bones were removed and kept in stomach so that brain can expand. After a day, in her CT scan it shows there is bleeding inside the brain and platelets less. She is unconsciousness from five days and able to breath much on ventilator. I want to know what are the chances of her survival. I am waiting for reply as she is in hospital right now fighting for life in PGI Chandigarh.

My sister had a brain bleed and was unconscious for a 6 hours waking a few times, she was moved to a neurology hospital where on arrival she became responsive answering the Drs questions. She had one brain scan, and the neuro team were going to give her another. Within 10 minutes of being responsive she started having seizures. She was operated on and found that another bleed had occurred and her brain had been too badly damaged and she died later on. Is this normal?

My sister had a tumor removed from her pituitary gland. The tumor was bigger than thought, and she had a brain bleed, fluid and her brain was swelling. Now because of the location of the blood, she can't open her eyes. She has a drain in and will put in a shunt later this week. I know every one is different and our bodies are different and react different. But how long will it take for this blood to be drained so she can open her eyes?

My 2 month old grandaughter has been admitted to the hospital my daughter said she stopped breathing after a bottle and nappy change she phoned for an abulance while her husband gave cpr the paramedics came and put a tube down her throat she started breathing again she was given a scan of her brain to rule out meningitis but they were told she has a bilateral brain bleed how has this happened why has this happened

What are the symptoms?

I was admitted to Royal London hospital on Monday with a suspected bleed on the brain. They wanted to admit me for a Lumbar puncture and MRI. As the royal london is 2 hours from my home I asked if i could be transferred to a hospital near my home. They agreed, discharged me and said that I should take a letter they gave me to my GP for the referral to the hospital nearer my home. The hospital have my referral and it was sent as urgent. My scan is now scheduled for anything up to 4 weeks. Surely this is too long for a suspected brain bleed? Any advice would be appreciated.

Going through this as we speak. My mother in law was sent to emergency by her doctor over two weeks ago with a suspected stroke. They did not do a cat scan and said she was just old and confused and sent her home. Two weeks later now her doctor made a ‘scheduled’ CT scan, they sent her straight to ER and she is currently (while I type this) having surgery to drain the old blood from two weeks ago. Slow brain bleed She most likely will have permanent damage from pressure and lack of octogenarian to parts of her brain.

Don’t take no for an answer. Keep going to emergency until the do a scan. It’s not worth waiting. If it’s a suspected bleed...the sooner you catch it, the better.

We don't live in the same city, or I would have pushed for the scan two weeks ago that’s why we came now! Hope you get help.

Hi. I was in a car crash over 6 months ago I had a minor bleed on the brain. I was told I was fine and sent home. I’ve been suffering with severe headaches ever since is this a sign of blood clotting on the brain? Severe headaches and every now and then a weird pain in the back of my left leg ?

My mom had a brain hemorrhage and a stroke and for some reason had an infection that the hospital could not have her find they eventually pretty much kicked her out of the hospital afyer 2 months into a nursing home and within two weeks she had passed away in my opinion I think she had sepsis and they never tested her for it could I be right on that topic

My mother passed away and I already talk to the doctor about how she passed away. They said she was brain dead by bleeding in the head but idk how that can occur they didn't say if she fell or want do they even know what exactly happen because she was staying with her bf that is abusive. I need answers it really hurts I feel so lost

My heart hurts with you. I feel sad about your loss and especially about how little you know about how your mother died.
Personally, I would feel lost most of the time if I didn't have someone strong and kind who is with me and helping me. hymnsradio has given me so many answers. I don't know if it might help?

I have concussion now for the 6 th time due to rugby can't remember anything from the match is it possibly bleeding on the brain

I have a very good friend that I found out had a recent sudden brain bleed, was in icu and not expected to make it, found out that he did but can not see or speak but is aware of his surrounding s, don't think I should go see him, don't know anything about him except what another friend of ours tells me that this guy's wife tells him I would like to see him eventually, but have also heard that he may end up in a nursing home, kiss of death, how can I be a friend to him and find out if his wife is telling the truth to our friends? ?

Go see him for yourself
. Life

Go see him for yourself. Life is too short for questions!!!!!!!!

mom fell, split her head open, required 6 staples, had a concussion and wound up with a brain bleed. as the blood receeded she started having 2 incidents of multiple strokes. What damage did the brain bleed cause???

Husband had a fall, head wound, stitches and two small brain bleeds.
What precautions should he take during recovery

Please can someone help me, my father has had his second craniotomy surgery in one month. He has a spontaneous bleeding from his brain, no one knows the cause? In 3 days he has lost 300 mls of fluid from his brain that’s in a drain attached to his head. He has confusion, disoriented. He’s 80 y/o. He had a stroke as well. He is in icu and I’m his daughter and I don’t feel I’m getting straight answers about his condition. Today has been day 5 and he’s still bleeding into the drain. Can anyone tell me when this will stop.

I am so very sorry you went through this. I hope he made it out okay. Sending prayers. God bless!

We are in a similar situation with my sister in law no straight answers. I found your comment on this website I’m doing research possibly ask about the bloodwork look at the MRI pictures or whatever they are Doing to help him and why. We pray for all of us

My husband fell down stairs from top to bottom .went to the hospital no scan offerd 2 weeks later he died from a catastrophic brain hemorrhage .if he had a scan would he still be alive

Not necessarily. And the brain damage may have been so bad it isn’t what either of you would have wanted. You can still get answers about his condition and i would if I were you.

My girlfriend had a stroke on one side of her brain and on the other had anurisum rupture at the same time. They removed a large part of her skull from her left side. They put it back on 3 months later. I never spoke to any of the Doctors her family took care of that.
But now I have her living with me and I don't know what to do for her.
She calls things like a bra she called it a strip. She does this a lot. Will this get better or is for life.

My son had this after a traumatic head injury and it is called Expressive Aphasia. He had had it for 10 years now and it seems better but it still happens now and then but not often. The thing is he doesn't realize he said the wrong word. Google it and it could help you. Good luck.

It’s called aphasia. My son had it after a motorcycle accident. It is the most difficult thing in the world. It does get better with therapy.

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

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?