Intracranial Hematoma: Types of Brain Bleeding and When Surgery Is Critical

April 22, 2026

Blogs, Emergency Medicine, Neurology, Neurosurgeon

Intracranial Hematoma: Types of Brain Bleeding and When Surgery Is Critical

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KIMS-SUNSHINE
Specialist,
22 April, 2026

Intracranial Hematoma_ Types of Brain Bleeding and When Surgery Is Critical

Intracranial bleeding or bleeding in the skull occurs when you have an injury or suffer from chronic hypertension, which is not under control. An intracranial hematoma is usually caused by a blood vessel that bursts, causing blood to leak and pool beneath the skull, putting pressure on brain tissue. A hematoma is a specific type of intracranial haemorrhage and will require critical care for brain injury. If you have hit your head but feel fine, you should still talk to a neurosurgeon for brain haemorrhage, as it can be life threatening in some cases. So, call us at KIMS Sunshine Hospital right away, as we are the best neurology hospital in Hyderabad.

Causes for Intracranial Hematoma to Occur-

A head injury is the main cause for brain bleeds to occur. Bad falls from bikes, cycles, sports injuries or assaults- these can harm your brain immensely. Even mild trauma is enough for a hematoma to form if you are an older adult- and you can still have symptoms even if there is no apparent injury from outside.

There are 3 possible types of intracranial hematomas, depending on where blood pools- epidural, subdural and subarachnoid bleed respectively- as in blood pools in between any one of the three layers of tissue that protect the brain.

Intracranial hematomas can be acute, subacute and chronic- depending on how quickly you develop symptoms after having the accident or injury. Acute hematomas need immediate treatment as symptoms show up instantaneously. Sub-acute hematomas may show symptoms a few weeks later while chronic hematomas can cause very slow bleeding in the brain and you may not show obvious symptoms either.

Symptoms of Intracranial Hematoma-

These are some of the symptoms that you may have or observe-

Sudden weakness on one side of the body – paralysis or numbness too, like a stroke.

You may have a very severe headache which is sudden in its onset. This is the most prominent symptom people notice right away.
You may feel very dizzy, nauseous and vomit.
You may slur your speech.
You may feel very tired.
You may have issues swallowing, along with a stiff neck.
Vision loss is also possible.
You may have poor balance and coordination.
You may also have seizures in some cases.
You may lose consciousness and fall into a coma in severe cases.

Even if you don’t notice symptoms right away, you should consider getting intracranial hematoma treatment, as this period is called the lucid interval. You are not safe! Call us now!

Diagnosis of Intracranial Hematoma-

Imaging is commonly used to assess a brain bleed. These are some of the tests that are done-

CT scan brain bleeding diagnosis- A CT scan can help doctors point a brain bleed very accurately and promptly.
An MRI or MRA can be done- to image blood vessels, soft tissue and how blood is flowing in them all and to check for clots or other blockages and abnormalities.
Other tests may also be done.

Treatment of Intracranial Hematoma-

Medications and emergency neurosurgery for brain bleed- these are two possible ways to treat this condition. Surgery can be done in different ways-

Craniectomy– A piece of your skull is removed, so that the location of the bleed can be ascertained.
Decompression – Burr holes are drilled to relieve pressure in the skull and help blood ooze out.
Craniotomy– A piece of your skull is surgically removed, to relieve pressure on your skull.

If the bleed is small, you won’t need surgery. But, you will need to take medications which either prevent complications or help ease whatever symptoms you may be having.

You may have to take anti-seizure medications, antidepressants, pain killers, corticosteroids, etc.

Conclusion

Head injury complications treatment is necessary within the golden hour. This will help reduce complications from developing and improve prognosis in the long term. Follow this rule of thumb- never stay home or go without medical help after a head injury, even if everything seems fine or normal. Talk to a specialist at KIMS Sunshine Hospital today!

Frequently Asked Questions

When is surgery required for brain bleeding?

Surgery is required when bleeding causes significant pressure on the brain, neurological deterioration, or risk of brain herniation. Warning signs include loss of consciousness, severe headache, repeated vomiting, weakness, seizures, or confusion. Large or expanding bleeds, or those that do not respond to medical management, need urgent surgical intervention to relieve pressure and prevent permanent damage.

Which specialist treats intracranial hematoma?

A neurosurgeon treats intracranial hematoma. These specialists are trained to manage bleeding in the brain through both surgical and non-surgical approaches. Care often involves a multidisciplinary team, including neurologists and critical care experts, to monitor brain function and guide recovery.

What types of intracranial hematomas require urgent surgery?

Types that often require urgent surgery include epidural hematomas, acute subdural hematomas, and large intracerebral hemorrhages causing mass effect. Rapidly worsening symptoms, midline shift on imaging, or increased intracranial pressure are key indicators. Prompt surgical evacuation helps prevent brain damage and improves survival in these high-risk situations.

How long is recovery after brain surgery for bleeding?

Recovery varies based on the severity of the bleed, the patient’s overall health, and the type of surgery performed. Initial hospital recovery may take days to weeks, while full neurological recovery can take several weeks to months. Rehabilitation, including physiotherapy and cognitive therapy, plays a crucial role in regaining function.

Where can I get emergency neurosurgical care?

Emergency neurosurgical care is available at hospitals with dedicated neurosurgery, trauma, and intensive care units. Look for centers equipped with advanced imaging, operating rooms, and 24/7 specialist availability. Rapid access to experienced neurosurgeons and critical care teams is essential for timely intervention and improved outcomes in brain emergencies.