What Causes a Brain Hemorrhage?   

What Causes a Brain Hemorrhage?

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March 26, 2021

Clinical Contributors to this story:

Many of us know that a brain hemorrhage means there is bleeding in the brain, but what actually causes one?

It’s helpful to understand that the bleeding can happen either inside the brain or outside of the brain but still within the skull. A hemorrhage can directly injure the brain or secondarily damage the brain through pressure reducing oxygen and blood flow to the compressed area. This causes further injury and killing brain cells.

Brain hemorrhages have a number of causes, including:

Head trauma

For people under the age of 50, the most common cause of a brain hemorrhage is a blow to the head caused by a fall or an accident.

High blood pressure

Chronic hypertension (high blood pressure) can weaken the walls of blood vessels and cause them to leak or burst. This is one of the more common types of brain hemorrhages experienced by older people, as well as one of the most preventable.

Amyloid angiography

Amyloid is a protein that can weaken blood vessels and make them brittle. “With certain patients, usually in the older population, the amyloid will be deposited in the blood vessels, causing them to be weak, and then you can have a hemorrhage from the blood vessels breaking,” says Thomas Steineke, M.D., a neurosurgeon and chairman of the Neuroscience Institute at JFK University Medical Center.


An aneurysm is a weakening in the blood vessels that swell and can burst. “Aneurysms were originally thought to be congenital, but the thinking now is they are atherosclerotic, caused by a buildup of plaque in your arteries—meaning the same condition that gives you heart attacks and strokes will cause some blood vessels to become weak and balloon out,” Dr. Steineke says.

Blood vessel abnormalities

Arteriovenous malformations are abnormally formed connections between the arteries and the veins. These congenital abnormalities cause weakness in the blood vessels that can rupture and cause a hemorrhage.

Other causes of bleeding in the brain include:

  • Bleeding disorders
  • Liver disease
  • Smoking
  • Alcohol or drug abuse
  • Certain conditions related to pregnancy and childbirth

Signs of Brain Hemorrhages

  • Sudden excruciating headache with:
    • Light sensitivity
    • Nausea
    • Vomiting
    • Neck stiffness

Treatment for Brain Hemorrhages

Treatment for a brain hemorrhage depends on its size, location and the amount of swelling it causes, but can include medication or surgery. Getting medical attention is the first step, and it’s important to do so quickly.

“If you ever suspect somebody having a brain bleed, they should be evaluated immediately,” says Dr. Steineke.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.


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