Guide to Recognising Signs Brain Haemorrhage
Learn how to recognise the critical signs of a brain haemorrhage, its causes, symptoms, and emergency response steps.
Written by Dr. Rohinipriyanka Pondugula
Reviewed by Dr. Vasanthasree Nair MBBS
Last updated on 17th Sep, 2025
Introduction
A brain haemorrhage is a medical emergency where bleeding occurs inside your skull. This sudden event can put catastrophic pressure on the brain, depriving it of oxygen and leading to rapid brain cell death. Unlike many health issues where a "wait-and-see" approach might be possible, a brain bleed is a race against time. Your ability to recognise the signs of a brain haemorrhage could literally save a life—whether it's your own or a loved one's. This guide cuts through the medical jargon to give you a clear, actionable understanding of what to look for. We will walk you through the critical symptoms, explain what causes this dangerous condition, and, most importantly, outline the immediate steps you must take. Knowing these signs empowers you to become a vital first responder in a crisis.
What Exactly is a Brain Haemorrhage?
A brain haemorrhage, also known as a cerebral haemorrhage or intracranial haemorrhage, refers to bleeding that occurs within the brain tissue or the spaces surrounding it. Think of your skull as a rigid, bony box designed to protect the soft, delicate brain. When a blood vessel within this confined space bursts, the escaped blood has nowhere to go. It pools and forms a mass called a hematoma. This hematoma compresses the brain tissue, disrupting its vital functions. Furthermore, the area of the brain that the ruptured vessel was supposed to supply with oxygen-rich blood is now starved, leading to a stroke (specifically, a haemorrhagic stroke).
The Brain Under Pressure: Why Bleeding is So Dangerous
The danger lies in the pressure. The skull cannot expand to accommodate the extra volume from the bleeding. This increased intracranial pressure (ICP) interferes with the brain's ability to function properly. It can disrupt crucial processes like breathing, heart rate, and consciousness. If the pressure becomes too great, it can force the brain downward through the small opening at the base of the skull (a process called herniation), which is often fatal. This is why the speed of recognition and treatment is paramount—the goal is to stop the bleeding and relieve the pressure before irreversible damage is done.
Consult a Specialist for the best advice
The Critical Signs: How to Recognise a Brain Haemorrhage
The symptoms of a brain haemorrhage can vary depending on the location and severity of the bleed, but they almost always appear suddenly and dramatically.
The Sudden and Severe Headache: The "Worst Headache of Your Life"
This is often the hallmark symptom. It's not a typical tension headache or a slow-building migraine. Patients commonly describe it as a thunderclap headache—an explosive, unbearable pain that peaks in intensity within seconds or minutes. It's frequently called "the worst headache of my life." If you or someone experiences a headache of this unprecedented severity, treat it as a red flag.
Neurological Symptoms: Weakness, Numbness, and Vision Problems
As the bleed affects specific parts of the brain that control movement and sensation, symptoms can include:
- Sudden weakness, numbness, or paralysis in the face, arm, or leg, often isolated to one side of the body.
- Acute vision problems, such as blurred, double, or lost vision.
- Loss of balance, coordination, or a sudden dizzy spell.
- Difficulty swallowing.
Cognitive and Sensory Changes: Confusion, Seizures, and Sensitivity
The brain's higher functions are also vulnerable. Look for:
- Sudden confusion, difficulty understanding speech, or slurred speech.
- Seizures without a previous history of epilepsy.
- Severe sensitivity to light (photophobia).
- Nausea and vomiting, especially when coupled with a severe headache.
The "FAST" Acronym for Stroke Symptoms (Ischaemic and Haemorrhagic)
Both major types of stroke share common warning signs. Remember FAST:
- Face: Ask the person to smile. Does one side of the face droop?
- Arms: Ask them to raise both arms. Does one arm drift downward?
- Speech: Ask them to repeat a simple phrase. Is their speech slurred or strange?
- Time: If you see any of these signs, call for an ambulance immediately.
Don't Wait: Why Immediate Action is Non-Negotiable
With a brain bleed, hesitation can be the difference between recovery, permanent disability, or death. Brain cells are dying every minute the pressure is not relieved.
The Golden Hour: How Time Affects Brain Tissue
The "Golden Hour" is a concept in emergency medicine referring to the critical window following a traumatic injury
where prompt medical treatment is most likely to prevent death. While not always a literal hour, the principle is the
same for a brain haemorrhage. The faster medical professionals can diagnose the problem and intervene, the better the chances of preserving brain function and ensuring a positive outcome.
What to Do While Waiting for an Ambulance
- Call for emergency services immediately. Clearly state you suspect a stroke or brain haemorrhage.
- Note the time when the symptoms first appeared.
- Keep the person calm and still. Have them sit or lie down in a safe position.
- Do not give them anything to eat or drink, as it may cause choking if their swallow reflex is impaired.
- Be prepared to provide information to the paramedics: symptoms, medical history, and any medications.
What Causes a Brain Haemorrhage?
High Blood Pressure (Hypertension): The Leading Cause
Chronic high blood pressure is the most common culprit. Over time, the constant force of high-pressure blood flow
weakens the walls of arteries, making them prone to cracking and rupturing. Managing hypertension is the single mosteffective way to reduce your risk.
Head Trauma and Aneurysms
- Trauma: A severe head injury from a fall, car accident, or assault is a leading cause, especially in younger people.
- Aneurysms: A bulging, weak spot in a blood vessel wall can burst, causing a subarachnoid haemorrhage.
- Arteriovenous Malformations (AVMs): Tangled blood vessels present at birth can rupture later in life.
Other Contributing Factors
These include use of blood-thinning medications (anticoagulants), bleeding disorders, liver disease (which can lead to increased bleeding risk), brain tumors, and illicit drug use (e.g., cocaine).
How is a Brain Bleed Diagnosed?
Upon arrival at the hospital, speed is essential. The primary tool for diagnosis is a CT scan (computed tomography). This imaging test can quickly and clearly show the presence of bleeding in the brain, its location, and the extent of the damage. In some cases, an MRI (magnetic resonance imaging) may provide more detailed images later on. A neurological exam will also be conducted to assess function. If you or a family member are experiencing worrying neurological symptoms, consulting a doctor online with Apollo24|7 can provide immediate initial guidance, but for suspected haemorrhage, always proceed to the nearest emergency room.
Treatment Options: Stopping the Bleed and Reducing Pressure
Treatment focuses on two goals: stopping the bleeding and relieving the pressure on the brain.
- Medication: Drugs may be given to control blood pressure, prevent seizures, reduce brain swelling, or reverse the effects of blood thinners.
- Surgery: In many cases, surgical intervention is necessary. This could involve a craniotomy (opening the skull) to drain the hematoma and repair damaged blood vessels or clip an aneurysm. Minimally invasive techniques may also be used.
Can a Brain Haemorrhage Be Prevented?
While not all causes are preventable, you can significantly reduce your risk by managing the factors within your control.
Managing Key Risk Factors
- Control Blood Pressure: This is the number one priority. Monitor it regularly and follow your doctor's advice on diet, exercise, and medication.
- Live a Heart-Healthy Lifestyle: Eat a balanced diet low in sodium and saturated fat, exercise regularly, maintain a healthy weight, and avoid smoking.
- Wear Protective Gear: Always use seatbelts and wear a helmet during activities like cycling or contact sports.
- Use Medication as Directed: Be aware of the risks associated with blood thinners and follow dosage instructions meticulously.
Conclusion
Recognising the signs of a brain haemorrhage is a critical piece of health knowledge that everyone should possess. The sudden and dramatic nature of its symptoms is a clear signal that the body is in crisis. Trust your instincts—if you witness someone experiencing the worst headache of their life coupled with neurological symptoms like weakness or confusion, your swift action to call emergency services is the most powerful intervention possible. This guide has equipped you with the knowledge to identify these warning signs. Share this information with your family and friends. Awareness saves lives. Your vigilance today could prevent a tragedy tomorrow.
Consult a Specialist for the best advice
Consult a Specialist for the best advice
Dr. Ganeshgouda Majigoudra
Neurologist
10 Years • MBBS, MD ( GENERAL MEDICINE) DM (NEUROLOGY)
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Aditendraditya Singh Bhati
Neurosurgeon
18 Years • MBBS(2004), DNB Neurosurgery(2014); MNAMS; Fellow Neuroendoscopy
Delhi
Apollo Hospitals Indraprastha, Delhi
(100+ Patients)
Dr. E Prabhakar Sastry
General Physician/ Internal Medicine Specialist
40 Years • MD(Internal Medicine)
Manikonda Jagir
Apollo Clinic, Manikonda, Manikonda Jagir
(125+ Patients)
Dr Rajashekar Mummadi
Neurologist
3 Years • MBBS, DNB General Medicine, DRNB Neurology
Hyderabad
Dr Ram's Neuro Clinic, Hyderabad
Dr S Selvin
Neurologist
10 Years • MBBS, MD, DM (Neurology), FINR fellowhsip in Interventional Neuro Radiology
Chennai
Apollo Speciality Hospitals Vanagaram, Chennai
Consult a Specialist for the best advice
Dr. Ganeshgouda Majigoudra
Neurologist
10 Years • MBBS, MD ( GENERAL MEDICINE) DM (NEUROLOGY)
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Aditendraditya Singh Bhati
Neurosurgeon
18 Years • MBBS(2004), DNB Neurosurgery(2014); MNAMS; Fellow Neuroendoscopy
Delhi
Apollo Hospitals Indraprastha, Delhi
(100+ Patients)
Dr. E Prabhakar Sastry
General Physician/ Internal Medicine Specialist
40 Years • MD(Internal Medicine)
Manikonda Jagir
Apollo Clinic, Manikonda, Manikonda Jagir
(125+ Patients)
Dr Rajashekar Mummadi
Neurologist
3 Years • MBBS, DNB General Medicine, DRNB Neurology
Hyderabad
Dr Ram's Neuro Clinic, Hyderabad
Dr S Selvin
Neurologist
10 Years • MBBS, MD, DM (Neurology), FINR fellowhsip in Interventional Neuro Radiology
Chennai
Apollo Speciality Hospitals Vanagaram, Chennai
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Frequently Asked Questions
1. Can you have a small brain bleed and not know it?
Yes, it's possible. A very small bleed might cause minor symptoms like a slight headache or dizziness that goes away. However, any bleed is serious and should be evaluated by a doctor, as it can be a warning sign of a larger event.
2. What is the difference between a stroke and a brain haemorrhage?
A stroke is an umbrella term for when blood supply to part of the brain is cut off. An ischaemic stroke is caused by a clot blocking a vessel. A haemorrhagic stroke (a brain haemorrhage) is caused by a burst vessel bleeding into the brain. Both are medical emergencies.
3. What are the chances of surviving a brain haemorrhage?
Survival rates depend heavily on the bleed's size, location, and how quickly treatment is received. While a brain haemorrhage is very serious, many people do survive, especially with prompt medical care. Recovery can be a long process involving rehabilitation.
4. How long can you live with a brain bleed without knowing?
You cannot live with an active, significant bleed without knowing for long, as symptoms are severe and rapid. However, a small, sealed-off chronic bleed might cause progressive symptoms over time, which is why any persistent neurological issue warrants a doctor's visit.
5. Can stress cause a brain haemorrhage?
While extreme stress can cause a temporary spike in blood pressure, it is not a direct cause. However, chronic stress contributes to long-term hypertension, which is the leading risk factor. Managing stress is an important part of overall cardiovascular health.