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What Is Intracranial Hemorrhage?
Intracranial hemorrhage refers to any bleeding within the skull, including bleeding in the brain. Bleeding between the membranes that surround the brain may reduce blood flow and increase pressure inside the skull, causing life-threatening symptoms that require immediate treatment.
What are the types of intracranial hemorrhage?
There are two types of intracranial bleeding: bleeding within the brain tissue itself (brain bleed) and bleeding between the meninges — the three membranes that surround the brain inside the skull — including the dura mater, arachnoid, and pia mater.
Types of brain bleeds
- Intracerebral hemorrhage — Bleeding anywhere in your brain tissue.
- Intraventricular hemorrhage — Bleeding in your brain’s ventricles, which produce cerebrospinal fluid (CSF).
Types of bleeding in the meninges
- Epidural bleed — Bleeding between the skull and the dura mater, the outermost membrane layer.
- Subarachnoid bleed — Bleeding between the arachnoid membrane and the pia mater.
- Subdural bleed — Bleeding between the dura mater and the arachnoid membrane.
How common is intracranial hemorrhage?
Intracranial hemorrhage is a common condition that can be caused by injury or disorders of the blood vessels in your brain.
What causes intracranial hemorrhage?
Several conditions can cause bleeding inside your skull, including:
- Blood vessel disorder, such as arteriovenous malformation (AVM).
- Brain tumors.
- High blood pressure.
- Injury, such as a skull fracture or traumatic brain injury.
- Narrowing of the arteries in your brain (atherosclerosis).
- Ruptured aneurysm.
What are intracranial hemorrhage risk factors and complications?
Intracranial hemorrhage risk factors
Intracranial hemorrhage can affect anyone, but certain conditions may increase your risk, including:
- Bleeding or blood vessel disorders.
- Head injuries.
- High blood pressure.
- Pregnancy and childbirth-related conditions, such as preeclampsia.
- Substance use disorder.
- Taking blood-thinning medications.
- Tobacco use.
Complications of intracranial hemorrhage
Intracranial bleeding is a life-threatening condition that requires emergency medical care.
If left untreated, it can result in death or long-term disability, including:
- Difficulty with thinking and memory.
- Numbness or weakness in parts of your body.
- Personality or emotional changes.
- Problems with movement, balance, or coordination.
- Swallowing and speech problems.
- Vision problems.
How can I prevent intracranial hemorrhage?
You may not be able to control some of your intracranial hemorrhage risk factors, such as accidental head injury. However, managing chronic conditions can reduce the risk that you will have intracranial bleeding.
You may be able to reduce your risk by:
- Eating a diet rich in fruits, vegetables, and whole grains.
- Exercising and maintaining a healthy weight.
- Maintaining normal blood pressure and cholesterol levels.
- Avoiding smoking and illicit drug use.
- Limiting alcoholic beverages.
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What Are the Signs and Symptoms of Intracranial Hemorrhage?
The most common symptom of intracranial hemorrhage is a severe and sudden headache. Most people describe it as the worst headache of their lives.
Other symptoms of intracranial hemorrhage may include:
- Abnormal heart rate.
- Confusion.
- Difficulty swallowing.
- Dizziness.
- Double vision or vision loss.
- Fatigue or sleepiness.
- Loss of balance.
- Loss of consciousness.
- Nausea and vomiting.
- Seizures.
- Sensitivity to light.
- Slurred speech.
- Stiff neck.
- Trouble breathing.
- Weakness, numbness, or tingling, often on one side of the body.
When should I see a doctor about my intracranial hemorrhage symptoms?
If you experience symptoms of an intracranial hemorrhage, you should call 911 immediately.
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How Do You Diagnose Intracranial Hemorrhage?
When you arrive at the hospital, your doctor will ask about your symptoms and perform physical and neurological exams to diagnose intracranial hemorrhage.
What to expect during your visit
If your doctor suspects intracranial hemorrhage, they will:
- Order imaging or other tests.
- Perform a physical and neurological exam.
- Review your health history and medications.
Tests to diagnose intracranial hemorrhage
Diagnostic tests for intracranial hemorrhage include:
- CT or MR angiogram (CTA or MRA) — Also known as arteriography or arteriogram, this test uses x-rays or magnets and a special contrast dye to look for problems with the blood vessels in your brain.
- CT scan — A test that creates images of your brain and is used to diagnose stroke or another type of brain injury.
- Doppler ultrasound — A noninvasive test that uses ultrasound waves to measure blood flow through your arteries and veins.
- Lumbar puncture (spinal tap) — Checks for blood in your cerebrospinal fluid.
- MRI — Uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of your brain.
Intracranial hemorrhage prognosis
Your prognosis after intracranial bleeding depends on several factors, including the severity of your condition and how quickly you receive medical treatment. In some cases, intracranial bleeding can be deadly. Some people who survive may have no long-term disability, but others may have permanent disability ranging from mild to severe.
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How Do You Treat Intracranial Hemorrhage?
The goals of intracranial hemorrhage treatment are to stop the bleeding and limit brain damage.
Your doctor may recommend treatment including:
Open surgery for intracranial hemorrhage
Surgery can stop intracranial bleeding and treat the underlying cause.
Types of surgery include:
- Aneurysm clipping — Involves placing a metal clip around the base of an aneurysm to control bleeding.
- Craniotomy — A procedure to remove and replace a piece of your skull to relieve pressure and treat the source of your bleeding.
- Decompression — A procedure to drill a hole in your skull to drain excess blood and relieve pressure.
Minimally invasive surgery for intracranial hemorrhage
UPMC surgeons perform minimally invasive procedures to treat intracranial hemorrhage by draining blood from the affected area of the brain and repairing the source of the bleeding.
These procedures can be performed through a small incision in the scalp or using a catheter inserted into a blood vessel and guided to the bleeding site.
Procedures include:
- Embolization — Blocks blood flow to abnormal blood vessels.
- Endoscopic evacuation — Uses a small instrument with a camera to remove blood clots from your brain.
- Endovascular coiling — Uses small coils to block blood flow to an aneurysm.
- External ventricular drain (EVD) — Uses a thin, flexible tube called a catheter to drain fluid and blood from your brain.
- Flow diverters — Uses small devices to block blood flow to an aneurysm.
- Stereotactic aspiration — Uses imaging guidance and small surgical instruments to remove blood clots from your brain.
Medication for intracranial hemorrhage
Your doctor may use medications to treat the underlying cause or complications of intracranial hemorrhage, including:
- Antianxiety medications.
- Anti-inflammatory medications, such as corticosteroids.
- Antiseizure medications.
- Blood pressure medications.
- Pain relievers.
Why choose UPMC for intracranial hemorrhage care?
When you choose UPMC for intracranial hemorrhage care, you will receive:
- Access to world-class stroke expertise — UPMC is among the world’s best multidisciplinary stroke and neurosurgery centers. When surgery is necessary, our stroke team is experienced in advanced treatments, including traditional and investigational approaches that are not widely available.
- A full range of treatment options — We offer minimally invasive care as well as traditional open surgical procedures, allowing us to effectively treat all types of intracranial hemorrhage while reducing your risk of complications.
- Multidisciplinary care — We partner with neurologists, rehabilitation specialists, and other medical experts to provide complete care that optimizes your recovery and quality of life.
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By UPMC Editorial Staff. Last reviewed on 2025-10-23.
