Symptoms:

The symptoms vary depending on the location of the bleed and the amount of brain tissue affected. Symptoms most commonly develop suddenly, without warning, often during activity. They may be episodic (occurring and then stopping) or slowly get worse over time. Symptoms may include:

• Change in alertness (level of consciousness)
  • Apathetic
  • Coma
  • Lethargy
  • Sleepiness
  • Stupor
  • Unconsciousness
  • Withdrawn
• Difficulty speaking or understanding others
• Difficulty swallowing
• Difficulty writing or reading
• Headache
  • Occurs when lying flat
  • Wakes you up from sleep
  • Gets worse when you change positions or when you bend, strain, or cough
  • Starts suddenly
• Loss of coordination
• Loss of balance
• Movement changes, usually on only one side of the body
  • Difficulty moving any body part
  • Loss of fine motor skills
• Nausea or vomiting
• Seizure
• Sensation changes, usually on only one side of the body
  • Decreased sensation
  • Numbness or tingling
• Weakness of any body part
• Vision changes
  • Decreased vision
  • Loss of all or part of vision

Signs and tests:

A neurological exam may suggest increased intracranial pressure or decreased brain function. The person's specific symptoms can help tell which part of the brain is affected. For example, sudden nausea, vomiting, loss of balance, headache, and a rapid decrease in consciousness can mean a bleed in the brain.

An eye exam may show swelling of the optic nerve from pressure in the brain, or there may be changes in eye movement. Abnormal reflexes may be present.

Tests may include:

• Angiogram of the head
• Complete blood count (CBC)
• Bleeding time
• Blood clotting tests (Prothrombin time or partial thromboplastin time)
• Head CT (may be preferred if bleed is less than 48 hours old)
• Liver function tests
• Kidney function tests
• MRI of head
• Platelet count