Symptoms:

• Headache, which may:
  • Occur when lying flat
  • Cause you to wake up
  • Increase when you change positions
  • Start suddenly
  • Increase when you bend, strain, or cough
• Nausea or vomiting
• Change in alertness (level of consciousness)
  • Apathetic, withdrawn
  • Sleepiness, lethargy, stupor
  • Unconsciousness, coma
• Decreased vision
• Loss of all or part of vision
• Sensation changes, usually on only one side of the body
  • Decreased sensation
  • Numbness or tingling
  • Abnormal sensations
• Difficulty speaking or understanding others
• Difficulty swallowing
• Difficulty writing or reading
• Movement changes, usually on only one side of the body
  • Weakness of any body part
  • Difficulty moving any body part
  • Loss of fine motor skills
• Loss of coordination
• Loss of balance
• Seizure

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.

Signs and tests:

A neurological exam may suggest increased intracranial pressure or decreased brain functions. 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 cerebellum or brainstem.

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:

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