Severe headache and blurred vision may be signs of internal bleeding in the head, especially after recently experiencing a traumatic accident. Learn more about the symptoms of internal bleeding in the head.
Internal bleeding in the head can cause blood accumulation and pressure on the brain, manifesting in several symptoms and signs. These symptoms may appear immediately after a head injury or may take days or even weeks to develop after the injury. It’s not necessary for the bleeding to follow a violent head injury; a blood vessel may rupture and cause severe bleeding without any injury. What are the causes of this?
Some people fear the possibility of hidden bleeding in the head without being aware of it. This issue should be given special importance due to the seriousness of some cases of internal bleeding on human life. Follow along to learn about the symptoms, causes, and treatment of internal bleeding in the head.
What are the symptoms of internal bleeding in the head?
Many people assume that the term “internal bleeding in the head” necessarily refers to bleeding that occurs inside the blood vessels of the brain, which is not entirely correct. In some cases, a blood clot may form around the brain inside the skull, causing symptoms by pressing on functional areas of the brain.
Maintaining proper pressure inside the head is essential for healthy individuals to prevent compression of the brain, which can be life-threatening. In cases of internal bleeding, the natural pressure in the head increases, resulting in the appearance of symptoms and signs of compression, including:
- Severe worsening headache
- Nausea and recurrent vomiting
- Tendency to drowsiness
- Blurred vision
- Difficulty concentrating
- Feeling dizzy and confused
- Incoherent speech (slurred speech)
- Unequal pupil size
- Muscle weakness or paralysis in one part of the body (often on one side, either right or left)
- Episodes of unconsciousness
The above are some of the prominent signs of internal bleeding in the head. Patients with head bleeding may experience one or most of these symptoms, depending on the location, severity, and size of the blood accumulation around the brain.
Causes of internal bleeding in the head
The most common cause of internal bleeding in the head is accidents and violent injuries to the skull, especially in children and young people due to their involvement in physical activities.
There are risk factors that may be responsible for internal bleeding without exposure to bruises or injuries, which are more commonly seen in older adults, including:
- High blood pressure and blood vessel rupture
- Blood clots that may lead to blood accumulation and leakage outside the vessel
- Aneurysm (abnormal vessel dilation)
- Arteriosclerosis (accumulation of protein plaques in blood vessel walls)
- Abnormal vascular formations that may cause bleeding
- Misuse of blood thinners and anticoagulants
- Diseases causing blood clotting disorders (hemophilia)
- Brain tumors or vascular tumors
- Smoking and alcohol
Types of internal bleeding in the head
Internal bleeding in the head has been classified into several types based on the location of the blood accumulation. We have the following types:
Bleeding in the layers surrounding the brain (meninges)
The meninges are three layers surrounding the brain to protect it and ensure sufficient blood and oxygen supply to the brain. Bleeding and blood accumulation may occur in one of these layers, making this type of bleeding more common than cerebral hemorrhage. It is divided into the following types:
Subdural hemorrhage
The dura mater is the superficial and most durable layer of the meninges. If a blood vessel is injured in this area, bleeding occurs, forming a hematoma in the space between the dura mater and the next layer of the meninges.
Symptoms of subdural hemorrhage typically develop gradually as the blood accumulation increases. The larger the blood bleed, the more the brain is compressed, and the symptoms appear rapidly. Patients may experience signs of progressively worsening consciousness and may enter into a coma.
This condition should be treated in the hospital as soon as possible to prevent the development of fatal complications. Subdural hemorrhage is classified into acute, subacute, and chronic types.
Bleeding above the dura mater
Blood accumulates in the space between the dura mater and the skull. Some patients with this type of bleeding remain conscious, while others may experience decreased consciousness and may even enter into a coma.
The most common cause of bleeding above the dura mater is severe contusions. Some patients may lose consciousness immediately after the accident and may be taken to the hospital unconscious.
Bleeding under the arachnoid mater
This type of bleeding is life-threatening and requires rapid emergency intervention in the hospital. In this pattern of meningeal bleeding, the hematoma is located between the arachnoid mater and the outermost layer of the meninges (the dura mater) and is the most common type of meningeal bleeding.
Intracerebral bleeding
As mentioned earlier, brain bleeding is one form of internal bleeding in the head. Cerebral hemorrhage is more dangerous than meningeal bleeding and requires rapid treatment because internal bleeding may reduce the amount of oxygen reaching the brain, leading to death of nerve cells and the occurrence of irreversible and serious complications. Read more about cerebral hemorrhage.
Diagnosis of internal bleeding in the head
Doctors always consider the possibility of internal bleeding in the head for anyone who has suffered a blow to the skull.
A loss of consciousness is the most important sign that prompts a doctor to suspect internal bleeding. However, this sign may not be observed in all bleeding patients. Some may not experience any signs or symptoms of internal bleeding despite having it.
Doctors may resort to one of the following methods to detect internal bleeding in the head:
CT scan of the head
Among the initial tests performed for patients with head injuries, this test allows for the detection of internal bleeding in the meninges or brain and determining the location and severity of the bleeding. However, it may fail to detect small blood clots.
Internal bleeding in the head appears as white densities on the CT scan image.
MRI scan
Using a magnetic field and radio waves, this device can provide a clearer image of the structure of the head and thus diagnose internal bleeding in its early stages, even if it’s small in size.
Treatment of internal bleeding in the head
Intracranial hemorrhage is a medical emergency that requires special attention and treatment in the hospital to prevent potential complications that may threaten the patient’s life.
If you have suffered a blow to the skull and begin to notice symptoms similar to those mentioned above, it is best to visit the hospital to confirm the absence of internal bleeding in your head. If internal bleeding is confirmed, it may be treated by:
Surgical drainage of the hematoma
Blood bleeding (hematoma) is usually drained through a small hole in the skull, and a tube (endoscope) is inserted to allow the surgeon to suction the blood accumulation after determining its location accurately.
In cases of severe bleeding, a neurosurgeon may resort to performing a craniotomy to be able to remove the blood clots to relieve skull pressure and control bleeding.
Treatment of risk factors
After completing emergency management and the patient passes the critical stage, a comprehensive assessment of the patient’s health can be conducted to eliminate factors that increase the risk of re-bleeding, such as controlling high blood pressure and adjusting blood-thinning medications if taken, and other measures that contribute to prevention.
In conclusion, knowing the symptoms of internal bleeding in the head allows for early detection before the condition becomes more serious. The causes of internal bleeding are not limited to blows alone; there are other causes of sudden bleeding, such as a torn artery in the brain due to high blood pressure and other reasons. Not all cases of head bleeding indicate cerebral bleeding, as internal bleeding can affect the layers surrounding the brain, known as the meninges. As for treatment, it includes hospitalization until the bleeding is treated and the critical stage is passed.
