With any kind of an injury to the brain, there’s a risk of swelling of the brain, which then can cause additional damage to the brain. Another situation is when you have bleeding on the brain, which creates a pocket of blood that then moves parts of the brain around, thereby injuring the brain. When those things happen, it’s a potential neurosurgery emergency, and folks are generally taken to the hospital for immediate evaluation. Sometimes surgery is required to relieve the pressure on the brain to prevent brain tissue death.
However, some bleeds are not considered emergencies. Sometimes they’re old, have already come and gone and they’re starting to shrink, or are so small that it hasn’t moved parts of the brain around yet. In those instances, we’re going to wait and see what happens with them. It’s really individualized whether or not someone will need surgery. If, after a brain injury, a person suddenly experiences a terrible headache, that is a clue that they may have a brain bleed and may need surgery.
Let’s say, for example, that you were on a bicycle, and you were hit by a car and you bumped your head. From the beginning, you are aware that you hurt your head, but you think little of it until a week later when you suddenly have the worst headache of your life. If that happens, it’s an emergency. You need to get it checked out right away because it could indicate a brain bleed needing immediate treatment.