Brain Haemorrhage: A Guide to Recognising the Critical Signs
Learn how to recognise the critical signs of a brain haemorrhage, understand its causes, symptoms, diagnosis, and when to seek emergency care.
Written by Dr. M L Ezhilarasan
Reviewed by Dr. Rohinipriyanka Pondugula MBBS
Last updated on 18th Sep, 2025
A brain haemorrhage is a life-threatening medical emergency where bleeding occurs inside your skull. This sudden event can disrupt the brain's vital oxygen supply, create dangerous pressure on delicate brain tissue, and lead to permanent damage or worse within minutes. Understanding the signs is not just about knowledge—it's about empowerment and the potential to save a life, whether it's your own or a loved one's. This guide cuts through the medical jargon to provide a clear, actionable roadmap to recognising the critical symptoms of a brain haemorrhage. We will explore the different types of bleeds, decode the often-subtle warning signs, discuss the primary causes, and outline the immediate steps you must take. Your ability to act fast could make all the difference.
What Exactly is a Brain Haemorrhage?
A brain haemorrhage, also known as an intracranial hemorrhage or hemorrhagic stroke, refers to bleeding that occurs within the brain tissue or the spaces surrounding it. Unlike a cut on your skin, blood leaking inside the confined space of the skull has nowhere to go. This pooled blood forms a mass called a hematoma, which presses on brain structures, disrupts neural pathways, and cuts off crucial oxygen and nutrient supply to brain cells, causing them to die.
The Brain Under Pressure: Why Bleeding is So Dangerous
The skull is a rigid box designed to protect the brain. However, this protection becomes a liability during a bleed. As blood accumulates, intracranial pressure rises. This pressure can:
- Crush delicate brain tissue against the hard skull.
- Displace brain structures (a condition called herniation), which is often fatal.
- Compress and damage the brainstem, which controls essential functions like breathing and heart rate.
1. Different Types of Brain Haemorrhages
The specific location of the bleed determines its type, cause, and severity.
Intracerebral Haemorrhage (ICH)
This is the most common type of spontaneous bleed, occurring within the brain tissue itself. It's often caused by high blood pressure suddenly bursting a small artery deep within the brain.
Subarachnoid Haemorrhage (SAH)
This bleed happens in the subarachnoid space—the area between the brain and the thin tissues that cover it. The classic symptom is a sudden, explosive headache. A ruptured cerebral aneurysm is a frequent cause.
Subdural and Epidural Haematomas
These are often related to head trauma. A subdural hematoma forms between the brain and its outermost covering, usually from tearing veins. An epidural hematoma forms between the skull and the brain's durable covering, often from a torn artery, and can cause rapid deterioration.
Consult Top Brain Specialists
Recognising a Brain Haemorrhage
Recognising the symptoms of a brain haemorrhage is the single most important factor in seeking timely help. Symptoms can appear suddenly and escalate quickly.
The Signature Symptom: The "Thunderclap" Headache
Often described as the "worst headache of your life," a thunderclap headache hits its peak intensity within seconds to a minute. It's a red flag that demands immediate medical attention. It is the hallmark symptom of a subarachnoid haemorrhage.
Neurological Red Flags
As pressure builds on the brain, it impairs function. Key signs include:
- Sudden numbness or weakness, especially on one side of the body (face, arm, or leg).
- Difficulty speaking (slurred speech) or understanding speech.
- Loss of balance, dizziness, or a sudden lack of coordination.
- Seizures without a previous history of epilepsy.
Physical and Sensory Symptoms
- Nausea and vomiting: Often sudden and severe.
- Vision changes: Blurred, double, or loss of vision.
- Sensitivity to light (photophobia).
- Altered consciousness: Confusion, drowsiness, lethargy, or loss of consciousness.
Symptoms in Infants
In babies, whose skulls are not fully fused, symptoms can be different. Look for a bulging soft spot on the head, unexplained irritability, a high-pitched cry, poor feeding, and seizures.
What Causes a Brain Haemorrhage?
Brain bleeds are generally categorised as either traumatic or spontaneous.
Traumatic Causes: Head Injuries
This is the leading cause of brain haemorrhage in people under 50. A sudden blow to the head from a fall, car accident, or assault can tear blood vessels. Symptoms might appear immediately or develop slowly over days (as with a chronic subdural hematoma).
Spontaneous Causes: Underlying Health Conditions
These occur without injury, often due to pre-existing weaknesses in blood vessels or other health issues.
High Blood Pressure (Hypertension)
Chronic hypertension weakens and stresses the walls of small arteries deep in the brain over time. This is the most common cause of an intracerebral haemorrhage.
Cerebral Aneurysm
An aneurysm is a weak, bulging spot on a brain artery wall. If it ruptures, it causes a catastrophic subarachnoid haemorrhage. Not all aneurysms rupture, and many are found incidentally.
Arteriovenous Malformation (AVM)
This is a rare, tangled web of abnormal blood vessels connecting arteries and veins in the brain. These fragile vessels are prone to leaking and rupturing.
Other causes include blood-thinning medications (anticoagulants), bleeding disorders, brain tumours, and amyloid angiopathy (a condition in the elderly where protein deposits weaken blood vessels).
Who is Most at Risk?
Certain factors increase the likelihood of experiencing a brain haemorrhage:
- Age: Risk increases with age.
- High Blood Pressure: The single most significant controllable risk factor.
- Smoking: Damages and weakens blood vessels.
- Heavy Alcohol Consumption: Can cause hypertension and makes falls more likely.
- Family History: Of aneurysms or strokes.
- Use of Blood Thinners: Such as warfarin or aspirin.
How is a Brain Haemorrhage Diagnosed?
Time is critical. In the emergency room, a CT scan (Computed Tomography) is the gold standard for quickly confirming a bleed. It can show the location, size, and extent of the hematoma. An MRI (Magnetic Resonance Imaging) may provide more detailed images later. If a subarachnoid haemorrhage is suspected, a CT angiography or a cerebral angiogram might be performed to locate the source of the bleeding, such as an aneurysm.
Treatment Options: A Race Against Time
The immediate goals of treatment for a brain bleed are to stop the bleeding, remove the pooled blood, and relieve pressure on the brain.
1. Medication: To control blood pressure, prevent seizures, reduce brain swelling, and reverse the effects of blood thinners.
2. Surgery: May be required to clip an aneurysm, remove an AVM, or, most commonly, to perform a craniotomy—where a section of the skull is removed to evacuate the hematoma and relieve pressure.
Recovery and Rehabilitation
Recovery is a marathon, not a sprint. The extent of recovery depends on the bleed's size and location. Many survivors require extensive rehabilitation, including physical, occupational, and speech therapy, to regain lost functions and adapt to new challenges. If you or a loved one are navigating the complex recovery process, consulting a specialist for a tailored rehabilitation plan is crucial. Platforms like Apollo24|7 can connect you with neurologists and physiatrists for ongoing online consultations to monitor progress.
Can a Brain Haemorrhage Be Prevented?
While not all brain haemorrhages are preventable, you can drastically reduce your risk by managing key health factors:
- Control Blood Pressure: This is the most important step. Monitor it regularly and adhere to prescribed medications.
- Quit Smoking and Vaping.
- Drink Alcohol in Moderation.
- Drive Safely: Always wear a seatbelt.
- Use Protective Gear: Wear helmets during cycling, contact sports, or riding motorcycles.
If you are on blood thinners, have your blood levels checked regularly as advised by your doctor. Apollo24|7 offers convenient home collection for essential monitoring tests like PT/INR, ensuring you can stay on top of your health safely from home.
Conclusion
Recognising the signs of a brain haemorrhage is a critical piece of health knowledge. It’s about understanding that a sudden, severe headache is not something to "sleep off" and that unexplained neurological symptoms demand instant action. This guide has equipped you with the knowledge to identify the warning signs, understand the causes, and appreciate the urgency required. Your awareness could disrupt a catastrophe. Remember, if you witness someone experiencing these symptoms, or if you experience them yourself, your immediate action—calling for emergency help—is the first and most vital step toward survival and recovery. If you have underlying risk factors like hypertension, don't wait for a warning sign. Consult a doctor online with Apollo24|7 for a comprehensive evaluation and a personalised management plan to protect your brain health today.
Consult Top Brain Specialists
Consult Top Brain Specialists
Dr. Lakshaman K
Neurologist
19 Years • MBBS,MS General Medicine,MCH Neurosurgery
Bengaluru
R V speciality Clinic, Bengaluru
Dr. Uddalak Chakraborty
Neurologist
8 Years • MBBS, MD(GENL.MED.),DM(NEUROLOGY)
Kolkata
MCR SUPER SPECIALITY POLY CLINIC & PATHOLOGY, Kolkata
(25+ Patients)
Dr. Uddalak Chakraborty
Neurologist
8 Years • MBBS,MD(GENL. MED.),DM(NEUROLOGY)
Kolkata
VDC Clinic, Kolkata
Dr. Aditendraditya Singh Bhati
Neurosurgeon
18 Years • MBBS(2004), DNB Neurosurgery(2014); MNAMS; Fellow Neuroendoscopy
Delhi
Apollo Hospitals Indraprastha, Delhi
(100+ Patients)
Dr. Ganeshgouda Majigoudra
Neurologist
10 Years • MBBS, MD ( GENERAL MEDICINE) DM (NEUROLOGY)
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Consult Top Brain Specialists
Dr. Lakshaman K
Neurologist
19 Years • MBBS,MS General Medicine,MCH Neurosurgery
Bengaluru
R V speciality Clinic, Bengaluru
Dr. Uddalak Chakraborty
Neurologist
8 Years • MBBS, MD(GENL.MED.),DM(NEUROLOGY)
Kolkata
MCR SUPER SPECIALITY POLY CLINIC & PATHOLOGY, Kolkata
(25+ Patients)
Dr. Uddalak Chakraborty
Neurologist
8 Years • MBBS,MD(GENL. MED.),DM(NEUROLOGY)
Kolkata
VDC Clinic, Kolkata
Dr. Aditendraditya Singh Bhati
Neurosurgeon
18 Years • MBBS(2004), DNB Neurosurgery(2014); MNAMS; Fellow Neuroendoscopy
Delhi
Apollo Hospitals Indraprastha, Delhi
(100+ Patients)
Dr. Ganeshgouda Majigoudra
Neurologist
10 Years • MBBS, MD ( GENERAL MEDICINE) DM (NEUROLOGY)
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
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Frequently Asked Questions
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 ischemic stroke (more common) is caused by a clot. A hemorrhagic stroke (a brain haemorrhage) is caused by bleeding. Both are medical emergencies but have different treatment paths.
Can you survive a brain haemorrhage?
Yes, survival is possible, especially with rapid medical intervention. The survival rate and quality of life afterward depend heavily on the bleed's size, location, and how quickly treatment was received.
What are the long-term effects after a brain bleed?
Long-term effects vary widely and can include physical challenges like paralysis or weakness, difficulty with speech and language, memory problems, fatigue, and emotional changes. Rehabilitation is key to managing these effects.
How long does it take to recover from a brain haemorrhage?
The most significant recovery typically happens in the first six months, but improvements can continue for years. Recovery is a lifelong process for many survivors.
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 sustained high blood pressure, which is a major risk factor for a spontaneous intracerebral haemorrhage.