Bleeding into the fluid-filled spaces deep inside the brain. It is the most common type in premature babies, whose developing blood vessels are especially fragile, and it is often graded from mild to severe.
Understanding Bleeding in a Newborn’s Brain
Hearing that your baby has bleeding in or around the brain is frightening, and many parents are left with more questions than answers. This page is here to help you understand what a brain bleed is, why it can happen around birth, and the options available to your family.
What is a brain bleed?
A brain bleed, known medically as an intracranial hemorrhage, happens when a blood vessel in or around the baby’s brain breaks and bleeds. These bleeds range widely in seriousness. Some are small, cause no lasting harm, and resolve on their own, while others are more serious and can affect a child’s development. The outlook often depends on where the bleeding is, how much bleeding occurs, and how quickly it is found and treated.
Brain bleeds are described by where they occur. Some happen inside the brain’s fluid-filled spaces, others in the layers of tissue that surround and protect the brain, and some beneath the scalp. Premature babies are especially vulnerable because the blood vessels in their developing brains are fragile, but bleeds can also happen in full-term babies, often in connection with a difficult or instrument-assisted delivery.
Signs and symptoms
Signs of a brain bleed can appear right after birth or in the first days of life, and they vary depending on how serious the bleed is. A small bleed may cause no obvious symptoms at all. When symptoms are present, they may include:
- Swelling of the scalp or an unusually enlarged head
- A high-pitched or unusual cry
- Trouble feeding
- Pauses in breathing (apnea)
- A bluish tint to the skin, lips, or nail beds
- Unusual sleepiness or low energy
- Seizures
Because some conditions that cause scalp swelling, such as caput succedaneum, are harmless, imaging like an ultrasound, CT, or MRI is used to see whether bleeding has actually reached the brain.
What causes bleeding in the brain?
Brain bleeds happen for different reasons, and often more than one factor is involved. Common causes and risk factors around birth include:
- Premature birth, which leaves the brain’s blood vessels fragile and prone to bleeding
- A difficult or prolonged labor that places pressure on the baby’s head
- The use of delivery instruments such as forceps or a vacuum, especially when both are used
- Trauma to the head during delivery
- Oxygen deprivation around the time of birth
- Bleeding or clotting disorders in the baby
- Very high or low blood pressure in the baby
Not every brain bleed can be predicted or prevented, and many are not caused by any medical error. In other cases, the injury is connected to how a delivery was managed.
When a brain bleed may be medical malpractice
Not every newborn brain bleed is the result of medical negligence. Some happen despite careful, appropriate care. That said, certain circumstances may point to negligence, such as:
- Using forceps or a vacuum improperly, or using both in a way that raises the risk of injury
- Continuing a difficult vaginal delivery when a cesarean section was the safer choice
- Failing to monitor the baby for signs of distress during labor
- Not recognizing or responding to a bleed after birth
- Delaying imaging or treatment once a brain bleed is suspected
- Failing to properly care for a premature baby known to be at higher risk
Whether a case involves malpractice depends on the medical records and the specific facts. The attorneys at Wais, Vogelstein, Forman, Koch & Norman, LLC work with medical experts to review what happened, determine whether the standard of care was met, and help families understand whether the injury could have been prevented.
Treatment and long-term outlook
Treatment depends on the type and severity of the bleed. Smaller bleeds may need only close monitoring with repeat imaging to confirm they are resolving. More serious bleeds are managed in a neonatal intensive care unit and may involve breathing support, medication to control seizures, careful management of blood pressure, and treatment of any underlying cause. In some cases, when bleeding leads to a dangerous buildup of fluid in the brain (hydrocephalus), a procedure may be needed to relieve the pressure.
Long-term outcomes vary widely. Many babies, especially those with smaller bleeds, recover fully. More significant bleeds can lead to lasting effects such as cerebral palsy, developmental delays, seizure disorders, or challenges with movement, vision, or hearing. Early intervention and therapies can make a meaningful difference for children who experience lasting effects.
If your baby suffered a brain bleed
If your child suffered a brain bleed and you believe the way your delivery or your baby’s care was handled may have played a role, you do not have to sort through it alone. The team at Wais, Vogelstein, Forman, Koch & Norman, LLC has spent decades helping families understand what happened during birth and seek accountability when the standard of care was not met. We work with medical experts to review the records, answer your questions, and explain your options at no cost to you.
Injury Types: Brain Bleeds
Recognizing the types of bleeding in and around a newborn’s brain.
Brain bleeds are grouped by where they occur, and the location often shapes how serious the bleed is and how it is treated. Understanding these differences can help families make sense of a diagnosis and ask the right questions.
Intraventricular hemorrhage (IVH)
Subarachnoid hemorrhage
Bleeding in the space just around the brain. This is a common type in full-term babies and is often less severe, though larger bleeds can still cause seizures or other problems.
Subdural hemorrhage
Bleeding between the layers of tissue that cover the brain. It is frequently linked to birth trauma and the pressure of a difficult or instrument-assisted delivery, and larger bleeds can press on the brain.
Subgaleal hemorrhage
Bleeding beneath the scalp, outside the skull. It is strongly associated with vacuum or forceps delivery and can be serious because a newborn can lose a significant amount of blood into that space.
Frequently Asked Questions
Common questions about newborn brain bleeds.
If your baby has been diagnosed with a brain bleed, you likely have questions. Here are answers to a few of the most common ones.
Can a brain bleed cause cerebral palsy?
It can. More serious brain bleeds, particularly bleeding deep inside the brain in premature babies, can damage areas that control movement and lead to cerebral palsy or other developmental challenges. Not every brain bleed causes lasting harm, though, and many smaller bleeds resolve without long-term effects. The connection depends on the type and severity of the bleed and how quickly it is treated.
Is a brain bleed always caused by medical malpractice?
No. Brain bleeds can happen even when a delivery is handled carefully and appropriately, and prematurity alone raises the risk. Malpractice may be involved when a bleed results from the improper use of delivery instruments, a delayed cesarean section, or a failure to recognize and respond to warning signs. Reviewing the medical records is the best way to understand whether the standard of care was met.
How are newborn brain bleeds treated?
Treatment depends on the severity. Smaller bleeds may need only close monitoring with repeat imaging, while more serious bleeds are managed in a neonatal intensive care unit with breathing support, seizure medication, and careful monitoring. If a bleed causes a harmful buildup of fluid in the brain, a procedure may be needed to relieve the pressure.
How long do we have to file a claim?
The deadline to file depends on the state where the care took place, and the time limits for a child’s case can differ from those for an adult. Because these rules vary and can be strict, it is best to speak with an attorney as early as possible so no important deadline passes. Wais, Vogelstein, Forman, Koch & Norman, LLC handles cases nationwide and can help you understand the deadline that applies to your situation.
