Brain bleeds (ICH)
Medically reviewed by Kurt Yaeger, MD, endovascular neurosurgeon · Updated September 2026
Key points
An intracerebral hemorrhage (ICH) is bleeding directly into the brain tissue, most often from long-standing high blood pressure. It is an emergency: call 911.
Early treatment focuses on controlling blood pressure and reversing blood thinners. For selected patients, removing the clot through a small opening can improve recovery.
Finding the cause matters: an angiogram can reveal a hidden vascular problem, such as an AVM or aneurysm, that needs its own treatment.
What is an intracerebral hemorrhage?
An intracerebral hemorrhage, or ICH, is bleeding directly into the brain tissue. The most common cause is long-standing high blood pressure, but bleeds can also come from blood thinners, an underlying vascular problem like an AVM or aneurysm, or a condition called amyloid angiopathy that weakens small blood vessels in older adults.
It usually starts suddenly, with a severe headache, weakness, confusion, or vomiting. It is an emergency: call 911.
How is it treated?
The first priorities are controlling blood pressure, reversing any blood thinners, and making sure the bleed is not growing. For selected patients, removing the clot through a small opening, using an endoscope or similar minimally invasive tools, can improve recovery. Recent research has made this an increasingly important option when it is done early and in the right patients.
Finding out why the bleed happened matters too. An angiogram can reveal a hidden vascular cause that needs its own treatment to prevent another bleed.
Recovery
Recovery from a brain bleed can take months, and it often continues well after the hospital stay. I will help you and your family understand where things stand, what to expect, and what can be done to lower the chance of it happening again.