Internal bleeding in the head

Symptoms of internal bleeding in the head and how to treat it

Severe headaches and blurred vision may be signs of bleeding inside the head, especially after you have been in a traumatic accident recently. Learn more about the symptoms of internal bleeding in the head.

Internal bleeding in the head may cause blood to press on the brain, manifesting in several symptoms and signs. These symptoms may appear immediately after exposure to a traumatic injury to the head and may sometimes take days or even weeks after the injury. The bleeding does not necessarily follow a violent trauma. On the head, a blood vessel may rupture and cause severe bleeding without any injury. What are the reasons for this happening?

Some people fear that there may be hidden bleeding inside the head without realizing it. This matter must be given particular importance to the seriousness of some cases of internal bleeding. Follow us to learn about the symptoms of internal bleeding in the head, its causes, and how to treat it.

What are the symptoms of internal bleeding in the head?

Some think the term "internal bleeding in the head" necessarily refers to bleeding within the brain's blood vessels, which is not always correct. Sometimes, blood may gather near the skull around the brain and cause symptoms by compressing functional areas of the brain.

Pressure is maintained inside the head in healthy people to prevent brain compression that may pose a threat to life. In internal bleeding, the average pressure in the head increases, causing symptoms and signs of compression, including:

  • Severe headache that gets worse
  • Frequent nausea and vomiting
  • The tendency to be drowsy
  • Blurred vision
  • Difficulty being able to focus
  • Feeling dizzy and confused
  • Some developAphasia)
  • The pupils of both eyes are of different diameters
  • Muscle weakness or paralysis in one part of the body (usually on the right or left side)
  • Loss of consciousness

What was previously mentioned is one of the most important signs of internal bleeding in the head. Patients with head bleeding may suffer from one or most of these symptoms, depending on the area of bleeding, its severity, and the hematoma size around the brain.

The most common symptom of internal bleeding in the head
The main symptoms of internal bleeding in the head

Causes of internal bleeding in the head

The most common cause of internal bleeding in the head is accidents and injuries that the skull is exposed to, especially in children and young people who are frequently involved in motor activities.

There are risk factors that may be responsible for internal bleeding without exposure to injuries, and they are more seen in the elderly, including:

  • High blood pressure and rupture of a blood vessel
  • A blood clot may cause blood to leak out of the vessel
  • Bursting aneurysm
  • amyloidosis (a buildup of protein plaques in the walls of blood vessels)
  • Abnormal vascular formations that may cause bleeding
  • Wrong use of blood thinners and anticoagulants
  • Diseases causing disorders of blood clotting (hemophilia)
  • Brain tumors or meningiomas
  • Smoking and alcohol

Types of internal bleeding in the head

Internal Head bleeding has been classified according to the place where the blood clot occurs, as we find the following types:

Bleeding in the layers surrounding the brain (meninges)

The meninges are three layers surrounding the brain to protect it and ensure adequate blood and oxygen access. Bleeding may occur in one of these layers, as this type of bleeding is more common than cerebral hemorrhage and is divided into the following types:

Subdural bleeding

The dura is the superficial and most durable layer of the meninges. If a blood vessel is injured in this area, bleeding occurs, and a hematoma forms between the dura and the next layer of the meninges.

Symptoms of subdural hemorrhage usually develop gradually with an increase in the hematoma size. The larger the hematoma becomes, the more the brain is compressed, and the symptoms appear quickly as the patient suffers from signs of progressive weakness in consciousness, and a coma may happen.

This condition must be treated in the hospital as soon as possible for fear of developing complications that could be fatal. This bleeding has been classified into acute, subacute, and chronic types.

Epidural bleeding

Hematoma in the space between the dura mater and the skull. Some patients with this type of bleeding remain conscious, while others notice weakness of consciousness and may get to the stage of coma.

The most common cause of epidural hemorrhage is severe trauma, and unconsciousness may occur immediately after the accident and the patient gets to the hospital unconscious.

Subarachnoid hemorrhage

This bleeding is life-threatening and requires rapid emergency intervention in the hospital. With this type of meningeal bleeding, the hematoma is located between the arachnoid layer and the last layer of the meninges (the pia mater). It is considered the most common type of meningeal bleeding.

Bleeding inside the brain

As mentioned earlier, bleeding in the brain is a form of internal bleeding in the head , It is more dangerous than meningeal bleeding and requires rapid treatment because internal bleeding may reduce the amount of oxygen reaching the brain, leading to the death of nerve cells and severe irreversible complications. Read more about Brain hemorrhage.

Types of internal bleeding in the head, which mainly divided into meningeal bleeding and intracerebral hemorrhage
Types of internal bleeding in the head

Diagnosis of internal bleeding in the head

Doctors always consider the possibility of internal bleeding in the head in every person who has had trauma to the skull.

Loss of consciousness is the most critical sign that lets the doctors suspect the presence of internal bleeding. Still, this sign may not be seen in all patients with bleeding, as some do not suffer from any signs and symptoms of internal bleeding, even though they have internal bleeding.

Doctors may resort to one of the following methods to detect internal head bleeding:

Ct scan

One of the first tests performed for patients with head trauma, this test allows the detection of internal bleeding in the meninges or the brain and the location and severity of bleeding. Still, it may fail to detect small-sized hematomas.

Internal cerebral hemorrhage appears as white lesions on the CT scan.

MRI image

Using a magnetic field and radio waves, this device can give a clearer picture of the structures of the head and diagnose internal bleeding in its early stages, even if it is of a small size.

How to treat internal head bleeding

Internal bleeding in the head is an emergency case that must be given special attention and treated in the hospital to prevent possible bleeding complications that may threaten the patient's life.

Suppose you were exposed to trauma to the skull and began to notice symptoms similar to the previously mentioned signs. In that case, it is better to go to the hospital to ensure that there is no internal bleeding in your head, and if it is proven that there is bleeding, treatment may be done by:

Hematoma drainage surgery

Bleeding (hematoma) is usually drained by making a small hole in the skull and inserting a tube (endoscope) that allows the surgeon to suction out the hematoma after locating it well.

In severe bleeding, the neurosurgeon may open the skull to withdraw the hematoma to relieve the pressure on the head and control the bleeding.

How to drain the hematoma endoscopically in Türkiye

Treat risk factors

After the emergency treatment is completed and the patient has passed the danger stage, a full assessment of the patient’s health can be carried out, and factors that increase the risk of bleeding happening again can be eliminated, such as controlling high blood pressure, adjusting blood-thinning medications if taken, and other things that contribute to prevention.

In the end, knowing the symptoms of internal bleeding in the head allows it to be detected early before it develops into a more severe condition. The causes of internal bleeding are not limited to injuries only, as there are other causes of sudden bleeding, such as the rupture of an artery in the brain due to high blood pressure. Head bleeding does not necessarily mean bleeding occurs inside the brain in all cases. Internal bleeding can affect the layers surrounding the brain, known as the meninges. The treatment includes a stay in the hospital until the bleeding is completed and the danger stage is passed.


  1. Wikipedia
  2. Healthline
  3. Medscape

Frequently Asked Questions

It is suspected that there is bleeding in the head by observing signs and symptoms such as sudden headache, poor awareness with frequent vomiting, difficulty concentrating, and other characteristics, especially when you had exposure to trauma or a blow to the head accompanying these symptoms.

Symptoms of internal bleeding may begin to appear immediately after an accident or severe injury to the head within two days or more from the accident. The patient usually feels a loss of consciousness, a severe headache, and blurred vision. Other symptoms may also be noticed due to pressure on functional areas in the brain. Include muscle weakness in one side of the body (the right or left), difficulty speaking, and the ability to concentrate. Symptoms may develop due to difficulty chewing or swallowing and may reach coma due to severe internal bleeding in the head.

The seriousness of the bleeding depends on its severity, the amount of blood collected, its location, and whether or not it compresses essential parts of the brain. However, internal bleeding in the head is considered dangerous. It must be taken care of for fear of its severe life-threatening consequences, especially in cerebral hemorrhage.

Symptoms may begin immediately after exposure to head trauma. They may take days or even weeks after the accident, depending on the size of blood collected in the head, the severity of the injury, and the cause of the bleeding.

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