Brain bleed symptoms include severe headaches, blurred vision, weakness on one side of the body, and a stiff neck. It is a medical emergency that requires hospital treatment.

A bleed on the brain is known as a hemorrhage, which is a type of stroke.

There are two types of bleed on the brain: intracerebral hemorrhage, where the bleed occurs within the brain tissue, and subarachnoid hemorrhage, where the bleed happens on the brain surface.

Head injuries that result in a brain bleed are usually subarachnoid hemorrhages, while high blood pressure is a more common cause of intracerebral hemorrhage. Both types of brain bleeds have similar symptoms.

Brain bleeds cause around 13% of strokes.

Although a brain bleed can be fatal, recovery is possible. A person may also experience long-term complications, such as epilepsy, or memory problems.

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There may be no warning signs of a bleed on the brain. For example, it could happen after someone falls and hits their head.

The symptoms can vary, depending on where the bleed occurs. Different parts of the brain are responsible for different functions, such as speech, memory, or movement.

A person with a bleed on the brain may experience:

  • sudden severe headache
  • stiff neck
  • feeling or being sick
  • confusion
  • sensitivity to light
  • difficulty moving or walking
  • shaking
  • seizures
  • passing out

A person could also have symptoms of a stroke. People should remember the signs and what to do, using the abbreviation FAST:

  • Face drooping
  • Arm weakness
  • Speech slurring
  • Time to call 911

Stroke is a medical emergency. A person should always call 911 if someone experiences symptoms of a bleed on the brain or stroke.

Through my eyes

“I felt a pulling sensation to the right, but it was as though my body wanted to stay left. And with any movement, no matter how slight, the spinning feeling became more intense. By the time the police and ambulance crew arrived, I was holding onto our bedframe for dear life.”

Read more of Tracy Lyn’s stroke experience.

A bleed in the brain usually results from a severe blow to the head or a ruptured aneurysm.

Brain bleed from a head injury

All serious head traumas need urgent medical attention. People with this type of injury may:

  • pass out
  • seem confused
  • have difficulty speaking
  • experience nausea and vomiting
  • have blood or fluid coming from their ears
  • find it hard to stay awake

Ruptured aneurysm

An aneurysm is a weakness in the blood vessel wall that bulges or swells. Aneurysms can rupture suddenly without warning and cause a bleed on the brain.

Aneurysms can be hard to detect before they burst, but common symptoms include headaches or double vision. They may rupture in response to head trauma, a rise in blood pressure levels, or physical activity or strain. This is why a brain bleed might happen if someone lifts something heavy or feels a strong emotion, such as anger, which raises their blood pressure.

Can a brain bleed go unnoticed?

If a brain bleed is small and slow, it may cause no symptoms or symptoms may be mild or delayed.

Sometimes, an aneurysm leaks a small amount of blood into the brain, called a sentinel bleed. Sentinel or warning headaches can occur days or weeks before a major rupture when an aneurysm has a small leak. However, only a small number of people have a sentinel headache before a rupture.

If a ruptured aneurysm causes a bleed, the symptoms, such as a “thunderclap headache”, occur suddenly and are very obvious.

Anything that damages blood vessels can increase a person’s risk of a brain hemorrhage. Risk factors can include:

Older adults have a higher risk of stroke, but it can also affect younger people.

Pregnancy contributes to an increased risk of hemorrhagic stroke, particularly in the third trimester and postpartum period. However, the incidence is low. This may be due to factors such as increased blood pressure and volume, and changes in how the blood clots.

In the United States, the risk of stroke is twice as high for Black people in comparison with white people. This may be because the risk of diabetes and obesity is higher in Black populations.

A person who has had a stroke is at a higher risk of another stroke. A person who has experienced a heart attack also has an increased risk.

Liver disease is another factor that can increase a person’s risk of stroke. A person who has damage to their liver may also increase the risk of bleeding in the body.

Genes may also play a part. Cerebral amyloid angiopathy is a genetic condition that can cause a loss of brain function with age. Proteins build up around the brain’s artery walls, and this may increase the risk of dementia, stroke, and epilepsy.

It may be obvious that a person has a brain bleed because of their symptoms. A clear cause, such as a head injury, or previous stroke, can also help with diagnosis.

A person will usually need tests in the hospital to diagnose a brain bleed. The most common is a CT scan, where a series of X-rays create a 3D picture of the brain.

In the case of an aneurysm, a doctor can inject a dye into the blood vessels that will show up on an X-ray to help locate it.

A lumbar puncture can also check for signs of a bleed. A doctor will take a small sample of fluid from the lower part of the spine with a needle.

If these tests show that a person has had a brain bleed, follow-up tests can give more information to help make a treatment plan.

A brain bleed can have several complications, and some take longer to present than others.

Early complications

An aneurysm may burst again, causing another bleed. The risk is higher in the first few days after a brain bleed. Symptoms are the same as the initial brain bleed, but are often more severe.

After a brain bleed, a blood vessel can spasm and narrow. This reduces the supply of blood to the brain and can cause brain damage. Symptoms include drowsiness and signs similar to a stroke.

Fluid can build up in the brain after a brain bleed. This can put pressure on the brain and cause a person to have headaches, vomiting, and blurred vision.

Later complications

Other complications can take longer to appear, and these include:

  • problems with memory
  • concentration
  • mood disorders
  • behavioral changes

According to the Brain Aneurysm Foundation, when an aneurysm ruptures, a person’s survival rate is 50%. A person who survives a brain bleed is also likely to have complications. Around 66% of people will experience neurological problems, such as issues with speech or memory.

The main symptom of a bleed in the brain is a sudden, severe headache. It may follow a head injury but can also be caused by a ruptured aneurysm, which typically has no warning signs.

A brain bleed is a serious medical emergency. Someone nearby should call 911 if a person has symptoms of a stroke or a bleed on the brain.

Recovery is possible, but a person may have complications. Close supervision by a medical professional after treatment can help reduce the risk of complications.