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Brain Bleeds

Fewer than 10% of “mild” brain injury victims have intracranial bleeding.

The swelling caused by bleeding gradually increases pressure on the brain because the skull cannot expand to accommodate any increase in its contents. The person’s symptoms worsen and new symptoms appear.

The first symptoms of increased pressure within the skull include worsening headache, impaired thinking, decreased level of consciousness and vomiting. Later, the person may become unresponsive and comatose. A pupil may widen.

The 48 hour period after a traumatic brain injury is the critical time period during which a bleed or herniation may develop or expand. However, bleeding can begin up to 2 weeks after a traumatic brain injury.

Intracranial bleeding is caused, most often, by a blow to the head. Arteries and veins in the brain are prone to injury from direct impact, and from shearing and twisting of brain tissue.


Brain bleeding is a potentially devastating secondary injury which can occur as a result of a traumatic brain injury. It is very important to always get medical help after a head injury and to remain aware, post injury, of the symptoms of brain bleeding or herniation. These symptoms must be treated as emergency conditions if they occur.

Please note: The information on this website is not meant to replace the advice of a medical professional. You should consult your health care provider regarding specific medical concerns or treatment.

However, Intracranial Bleeding is a common and serious
consequence of severe traumatic brain injury.

Transtentorial Herniation

The most common type of herniation is a transtentorial herniation. Part of the temporal lobe is forced through the tentorial notch which is an opening between the temporal lobe and cerebellum. This displacement may be caused by a subdural hematoma which is a collection of blood on the surface of the brain.

Epidural Hematoma

A less common hematoma, the epidural, is bleeding between the inside of the skull and the outer covering of the brain. The bleeding causes swelling and compression of brain tissue, thus damaging it.

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