What is a Brain Bleed or Brain Hemorrhage?

What is a Brain Bleed or Brain Hemorrhage?

A brain bleed, also known as a brain hemorrhage, refers to bleeding between the brain tissue and the skull or inside the brain tissue. This is a life-threatening condition that requires immediate medical attention. Brain bleeds can limit the oxygen supplied to the brain, causing headaches, nausea, vomiting, tingling in the extremities, or facial paralysis.

Doctors refer to the two main areas of the brain affected when determining the type of brain hemorrhage:

  • Bleeding within the skull but outside the brain tissue
  • Bleeding within the brain tissue itself

Types of Brain Bleeds

  • Bleeding within the skull but outside the brain tissue

    The brain consists of three membrane layers called meninges. The meninges cover and shield the brain from injury. These layers are located between the skull bone and the brain tissue itself. A brain hemorrhage can happen anywhere within these three membranes: the dura mater, arachnoid, and pia mater.
    • Epidural hemorrhage - This type of bleed occurs between the skull bone and the dura mater (outermost) membrane level
    • Subdural hemorrhage - This brain bleed takes place between the dura mater (outermost) and the arachnoid membrane
    • Subarachnoid hemorrhage - This type of brain bleed occurs between the arachnoid membrane and the pia mater
  • Bleeding inside the brain tissue

    Two types of brain bleeds can occur inside the actual brain tissue. This is referred to as a cerebral hemorrhage or a hemorrhagic stroke.
    • Intracerebral hemorrhage - Bleeding that occurs in the cerebellum of the brain (including the brainstem)
    • Intraventricular hemorrhage - Bleeds that originate in the brain cavities where cerebrospinal fluid is produced

Signs & Symptoms of Brain Bleed


The symptoms of a brain bleed, or intracranial hemorrhage, differ depending on which part of the brain is affected.

Common brain bleeds symptoms include:

  • Weakness, numbness, tingling, and facial paralysis. Often these symptoms affect the arm and leg on one side of the body.
  • Sudden, severe headaches known as “thunderclap” headaches. These headaches occur with subarachnoid hemorrhages. They are extremely painful and abrupt, with intense pain lasting from one to five minutes. This type of headache is not always dangerous; however, it could indicate a more serious, underlying condition involving a brain hemorrhage.
  • Nausea and vomiting
  • Confusion
  • Feeling lightheaded and dizzy
  • Seizures
  • Difficulty swallowing
  • Impaired vision or loss of vision, sensitivity to light
  • Difficulty with balance and coordination
  • Stiff neck
  • Slurred or unusual speech
  • Comprehension difficulties while reading, writing, or understanding
  • Feeling lethargic and sleepy
  • Difficulty breathing and abnormal heart rate (blood in the brainstem)
  • Coma

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What Causes a Brain Hemorrhage?


Though a brain hemorrhage can come on suddenly, there are underlying factors that can contribute. The most common causes of a brain hemorrhage are:

  • Head trauma - Injuries to the head are the most common reason for a brain hemorrhage to occur in people younger than 50 years old
  • High blood pressure - High blood pressure, if left untreated, can weaken the blood vessel walls and lead to a brain hemorrhage
  • Aneurysm - An aneurysm occurs when a blood vessel wall weakens and swells. A burst aneurysm can cause bleeding in the brain and lead to stroke.
  • Blood vessel abnormalities – An arteriovenous malformation (AVM) causes blood vessels in and around the brain to become weak. It may be present at birth but is only discoverable when symptoms appear.
  • Amyloid angiopathy - This blood irregularity usually occurs among older adults with high blood pressure. It may produce small bleeds that go unnoticed until finally causing a larger bleed.
  • Blood or bleeding disorders - People who have diseases such as hemophilia and sickle cell anemia are more likely to experience brain bleeds. Their conditions contribute to lower levels of blood platelets and clotting. Additionally, patients on blood thinners have an increased risk of brain bleeds.
  • Liver disease - People with liver conditions have an increased risk of bleeding issues
  • Brain tumors -Those who have had brain tumors are at a higher risk of developing a brain hemorrhage
Get Care

Trust NewYork-Presbyterian for Brain Hemorrhage Treatment

Knowing the signs and symptoms of a brain hemorrhage could save your life. NewYork-Presbyterian has a caring team of doctors and specialists who offer clinical trials and the most advanced treatments for neurological care services.

If you believe you have suffered a brain bleed, don’t wait. Contact your physician or go to the emergency room.