Concussions are a type of traumatic brain injury (TBI). In rare cases, an acute hemorrhage occurs: a blood vessel in the brain ruptures and blood fills the brain area rapidly. The person who suffered the concussion may initially seem fine, but as the blood accumulates, pressure builds in the skull and the brain tissue is compressed. This compression and increased pressure inside the skull can lead to additional brain injury, unconsciousness, and even death.

See Concussion Symptoms

Warning signs of brain hemorrhage in adults

Adults should contact a health care professional or go to an emergency department immediately if they experience any of these danger signs after a bump, blow, or jolt to the head or body:

  • Headache that gets worse and does not go away
  • Weakness, numbness or decreased coordination
  • Repeated vomiting or nausea
  • Slurred speech
  • Looks very drowsy or cannot be awakened
  • Has one pupil (the black part in the middle of the eye) that is larger than the other
  • Has convulsions or seizures
  • Cannot recognize people or places
  • Seems to be getting more and more confused, restless, or agitated
  • Shows unusual behavior
  • Loses consciousness

Even a brief loss of consciousness should be taken seriously and the person should be carefully monitored.


Warning signs of brain hemorrhage in children

A child should receive professional medical care right away if they received a bump, blow, or jolt to the head or body and display any one of these danger signs:

  • Have any of the danger signs for adults listed above
  • Will not stop crying and cannot be consoled
  • Will not nurse or eat

When in doubt, a caregiver should call for medical help or bring the child to an emergency department without delay.


Concussion, brain hemorrhage, hematoma, and blood clot

A hemorrhage results in a hematoma, which is a collection of blood. This collection of blood is sometimes, but not always, clotted into a solid or semi-solid mass. For this reason, the event is sometimes referred to as a blood clot on the brain.

A brain hemorrhage may be referred to as epidural, subdural, or subarachnoid hemorrhage depending on where the bleeding is located:

  • Epidural hemorrhages describe bleeding between the brain’s thick outer lining, called dura mater, and the skull.
  • Subdural hemorrhages (most common) describe bleeding between the brain and the dura mater.
  • Subarachnoid hemorrhages describe bleeding between the brain and the thin tissues that immediately surround it.
  • Intracerebral hemorrhages occur inside the brain itself

If a brain hemorrhage is suspected, a doctor will order a CT scan or other medical imaging.

Dr. Sean Colio is a sports medicine physician specializing in the treatment and prevention of sports and musculoskeletal injuries. He serves as a Clinical Assistant Professor in the Department of Orthopaedic Surgery at Stanford University. Dr. Colio co-founded the Sports Concussion Clinic at Swedish Spine, Sports & Musculoskeletal Medicine.

Dr. Renee Low is a neuropsychologist at the Sutter Medical Foundation, specializing in deep brain stimulation, sports-related concussions, traumatic brain injury, dementia, and other neurological issues.