Infant Brain Bleeds: Signs, Symptoms, & Causes

Key Takeaways:

• Infant brain bleeds, also called intracranial hemorrhages, occur when blood vessels rupture in or around a baby’s brain. Premature infants are at the highest risk, but full-term babies can also suffer brain bleeds due to birth trauma, oxygen deprivation, delayed C-sections, maternal infections, or improper use of delivery instruments.
• The four main types of infant brain bleeds are intraventricular hemorrhage (IVH), subdural hemorrhage, subarachnoid hemorrhage, and intracerebral hemorrhage. IVH is especially common in premature infants, and severe Grade III or IV bleeds can lead to complications such as hydrocephalus, cerebral palsy, seizures, developmental delays, and cognitive impairment.
• Common signs and symptoms of brain bleeding in infants include seizures, bulging soft spots on the head, poor feeding, weak sucking, unusual sleepiness, breathing problems, vomiting, irritability, abnormal muscle tone, and reduced responsiveness. Symptoms may appear immediately after birth or worsen gradually over several days as pressure builds inside the skull.
• Doctors diagnose infant brain bleeds using neurological exams and imaging tests such as cranial ultrasounds, CT scans, MRIs, and EEG monitoring. Treatment depends on the severity of the hemorrhage and may involve NICU care, seizure medication, respiratory support, surgery, hydrocephalus treatment with VP shunts, and long-term rehabilitation therapies like physical, occupational, and speech therapy.
• Severe infant brain bleeds can cause lifelong complications, including cerebral palsy, epilepsy, developmental delays, learning disabilities, feeding difficulties, vision or hearing loss, and behavioral challenges. In some cases, families pursue legal action when delayed medical intervention, improper delivery techniques, or failure to recognize fetal distress may have contributed to a preventable brain injury.

An infant brain bleed, also called an intracranial hemorrhage, occurs when blood vessels rupture inside the skull and release blood into or around the brain. While small hemorrhages may resolve with monitoring and supportive treatment, more severe bleeding can damage brain tissue, interrupt oxygen flow, and interfere with normal brain development.

Premature infants face a higher risk because the blood vessels near the brain’s ventricles are thin and vulnerable to rupture. According to the National Institutes of Health, intraventricular hemorrhage appears most frequently in babies born before 32 weeks of pregnancy or weighing less than 3.3 pounds at birth. Full-term infants can also suffer brain bleeds after prolonged labor, delayed cesarean delivery, untreated maternal infections, or excessive force during childbirth.

For many families, the diagnosis also raises difficult questions about the medical care provided during pregnancy, labor, and delivery. When physicians fail to respond to fetal distress, delay emergency intervention, misuse delivery instruments, or overlook warning signs after birth, a preventable brain injury can occur. 

What Is an Infant Brain Bleed?

As we explained above, an infant brain bleed happens when blood escapes from damaged vessels inside a baby’s skull and collects in or around the brain. Medical providers refer to these injuries as intracranial hemorrhages. The condition can develop before birth, during labor and delivery, or shortly after birth because of trauma, oxygen deprivation, clotting disorders, or complications linked to premature birth.

The severity of a brain bleed depends on several medical factors, including: 

• The location of the bleeding
• Amount of blood released
• How long pressure has been building inside the skull before treatment begins

Doctors classify infant brain bleeds based on where the bleeding occurs inside the skull. Each type has its own risks, symptoms, and long-term outcomes.

Types of Infant Brain Bleeds

Intraventricular Hemorrhage (IVH)

Intraventricular hemorrhage is one of the most common brain bleeds diagnosed in premature infants. It develops when bleeding occurs inside the ventricles, which are fluid-filled spaces deep within the brain. IVH appears most frequently in babies born before 32 weeks of pregnancy because immature blood vessels near the ventricles can rupture under stress.

Doctors divide IVH into four grades based on the amount of bleeding and the extent of brain involvement. Grade I hemorrhages involve small areas of bleeding near the ventricles and may resolve without lasting injury. At the other end of the spectrum, grade IV hemorrhages involve bleeding that extends into brain tissue itself and carry a much higher risk of developmental disability, cerebral palsy, and cognitive impairment.

Subdural Hemorrhage

A subdural hemorrhage happens when blood collects between the brain and the dura mater, which is the outer protective membrane covering the brain. This type of bleeding is frequently associated with traumatic deliveries, prolonged labor, excessive force during childbirth, or misuse of vacuum extractors and forceps.

Pressure from accumulated blood can compress brain tissue and interfere with normal neurological function. Some infants develop symptoms immediately after delivery, while others worsen gradually over several days as bleeding continues or swelling increases.

Signs of a subdural hemorrhage may include: 

• Seizures
• Irritability
• Poor feeding
• Vomiting
• Unequal pupil size
• Breathing problems
• Reduced responsiveness

Severe subdural bleeding can cause long-term brain damage if doctors fail to identify and treat the injury quickly.

Subarachnoid Hemorrhage

Subarachnoid hemorrhage involves bleeding between the brain and the thin membrane called the arachnoid layer. This form of bleeding is more common in full-term infants than other types of neonatal hemorrhage. Some cases result from birth trauma, while others develop without a clearly identifiable cause.

Mild subarachnoid hemorrhages may produce few symptoms and resolve with supportive care. More serious cases can irritate brain tissue and trigger seizures, breathing abnormalities, muscle stiffness, or feeding difficulties.

Doctors usually diagnose subarachnoid hemorrhage through imaging studies after a baby develops neurological symptoms shortly after birth. Monitoring remains important because symptoms can worsen if swelling or additional bleeding develops.

Intracerebral Hemorrhage

An intracerebral hemorrhage occurs when bleeding develops directly inside the brain tissue itself. This type of hemorrhage can destroy surrounding brain cells and interrupt the brain’s oxygen supply within minutes. Causes include: 

• Severe oxygen deprivation
• Clotting disorders
• Infections
• Traumatic delivery injuries
• Major complications affecting blood flow during labor

Infants with intracerebral hemorrhages may experience seizures, paralysis on one side of the body, breathing instability, extreme lethargy, or coma-like symptoms. Large hemorrhages may also increase intracranial pressure to dangerous levels that need emergency surgical treatment. Some children later develop learning disabilities, speech impairments, seizure disorders, or major motor impairments linked to the injured areas of the brain.

Signs and Symptoms of Brain Bleeding in Infants

The symptoms of an infant brain bleed can appear immediately after birth or develop gradually over several hours or days. Some newborns show dramatic neurological changes within minutes, while others display subtle symptoms that become more noticeable as pressure inside the skull increases. 

• Bulging or Swollen Soft Spot: The fontanelle is the soft area on top of a baby’s head where skull bones have not yet fused together. When bleeding or fluid buildup increases intracranial pressure, this area may appear swollen, tense, or firm instead of soft and slightly curved inward.
• Seizures: Newborn seizures may look very different from those in older children and adults. Instead of full-body convulsions, an infant may display repetitive lip smacking, rapid eye movements, jerking in one arm or leg, stiffening episodes, or repeated twitching that doesn’t stop when touched. 
• Poor Feeding and Weak Sucking: Babies with brain bleeds frequently struggle with feeding because neurological injury can interfere with sucking, swallowing, and coordination. Poor feeding can quickly lead to dehydration, unstable blood sugar levels, and weight loss in newborns. 
• Unusual Sleepiness or Reduced Responsiveness: Newborns naturally sleep for long periods, but excessive lethargy may point to brain dysfunction caused by bleeding or swelling. Infants with intracranial hemorrhages may become difficult to wake, stop responding normally to sound or touch, or show reduced movement during wake periods. 
• Breathing Problems and Changes in Heart Rate: The brain controls breathing patterns and heart rate regulation. When bleeding damages or compresses these areas, newborns may develop apnea episodes, irregular breathing, reduced oxygen levels, or slowed heart rates.
• Abnormal Muscle Tone and Body Movements: Brain bleeding can interfere with the nervous system signals that control muscle movement and coordination. Some infants become unusually stiff and arch their backs repeatedly. Others appear floppy, weak, or unable to move their limbs normally. 
• Vomiting and Irritability: Persistent vomiting in a newborn can indicate rising intracranial pressure caused by bleeding or swelling inside the skull. Infants may also become unusually irritable and difficult to soothe because pressure on brain tissue causes discomfort and neurological dysfunction. 

Common Causes of Infant Brain Bleeds

Infant brain bleeds develop for several medical reasons, but many cases involve problems that interrupt normal blood flow, damage fragile blood vessels, or place excessive pressure on a baby’s head during labor and delivery. 

Premature Birth

Premature infants have the highest risk of intraventricular hemorrhage because blood vessels inside the brain have not fully matured before birth.  Premature newborns also frequently experience breathing instability, rapid blood pressure changes, infections, and oxygen deprivation during the first days of life. These complications place additional stress on already fragile brain tissue. 

Birth Trauma During Labor and Delivery

During prolonged labor, the infant’s head may remain compressed inside the birth canal for extended periods, reducing oxygen delivery and increasing stress on delicate blood vessels. If labor stalls or fetal distress develops, doctors may need to perform an emergency cesarean section to reduce the risk of brain injury.

Traumatic deliveries become even more dangerous when physicians apply excessive force while attempting vaginal delivery. Shoulder dystocia, abnormal fetal positioning, and large birth weight can all increase pressure on the infant’s head during extraction. These complications may contribute to subdural hemorrhages and other traumatic brain injuries.

Improper Use of Forceps and Vacuum Extractors

Forceps and vacuum extraction devices can assist delivery when complications arise, but improper use may cause severe head trauma in newborns. For example:

• Vacuum extractors use suction to help guide the baby through the birth canal. Excessive suction force, repeated vacuum attempts, or incorrect placement on the baby’s head can damage blood vessels and increase the risk of intracranial bleeding.
• Forceps are placed around the baby’s head to assist delivery. Incorrect positioning or excessive traction may compress the skull and injure underlying brain tissue. Research has linked difficult operative vaginal deliveries to subdural hemorrhages, skull fractures, nerve injuries, and oxygen deprivation.

Medical providers must carefully evaluate fetal position, labor progression, and signs of distress before using delivery instruments. When safer alternatives exist, delayed intervention or poor clinical judgment can increase the risk of preventable injury.

Oxygen Deprivation During Birth

Oxygen deprivation, also called hypoxia or birth asphyxia, can damage brain tissue and weaken blood vessels inside the skull. When the brain doesn’t receive adequate oxygen, blood flow patterns change rapidly and place additional stress on fragile vessels. Severe oxygen deprivation may lead to hemorrhage, swelling, and permanent neurological injury within a short period of time.

Several labor complications can reduce oxygen delivery to the baby. For example: 

• Umbilical cord compression, placental abruption, uterine rupture, and prolonged fetal distress all interfere with normal oxygen exchange. 
• Abnormal fetal heart rate patterns frequently provide early warning signs that the baby is not tolerating labor safely.

Doctors and nurses must respond quickly when fetal monitoring strips show dangerous heart rate abnormalities. Delayed cesarean delivery or failure to intervene after signs of distress may increase the risk of brain bleeding and hypoxic brain injury.

Maternal Infections and Pregnancy Complications

Severe maternal infections can trigger inflammation that damages fetal blood vessels and interferes with normal clotting function. For example: 

• Conditions such as chorioamnionitis, meningitis, and untreated systemic infections may contribute to neurological injury in newborns.
• High blood pressure disorders during pregnancy, including preeclampsia, can also affect blood flow between the placenta and fetus. Reduced oxygen delivery and placental dysfunction increase the likelihood of premature birth and fetal distress.
• Blood clotting disorders in either the mother or infant may also contribute to hemorrhage risk. Babies born with clotting deficiencies can develop spontaneous bleeding inside the brain even without major delivery trauma.

Delayed Diagnosis After Birth

A baby showing seizures, feeding problems, weak muscle tone, or breathing instability needs immediate neurological evaluation and imaging studies. Failure to order timely cranial ultrasounds, CT scans, or MRIs can postpone life-saving treatment. In severe cases, delayed recognition of a hemorrhage allows hydrocephalus, oxygen deprivation, and brain compression to continue for hours or days before intervention begins.

How Doctors Diagnose Infant Brain Bleeds

The diagnostic approach depends on the infant’s age, symptoms, medical stability, and birth history. Babies who experienced traumatic deliveries, prolonged oxygen deprivation, or emergency resuscitation typically need closer neurological evaluation because these complications increase the risk of intracranial hemorrhage.

• Physical and Neurological Examination: Doctors evaluate the infant’s muscle tone, reflexes, breathing patterns, heart rate stability, eye movements, and responsiveness to stimulation. They also examine the fontanelle for tension or bulging and look for unequal pupil size, abnormal body posturing, tremors, or seizure activity. 
• Cranial Ultrasound: This test uses sound waves to create images of the brain through the infant’s fontanelle. It helps physicians identify bleeding near the ventricles, enlarged ventricles caused by fluid buildup, and changes linked to hydrocephalus. However, smaller areas of bleeding or injuries affecting deeper brain tissue may call for additional imaging for a more complete evaluation.
• CT Scans: Computed tomography scans, commonly called CT scans, create detailed cross-sectional images of the brain using X-ray technology. CT imaging allows doctors to quickly identify active bleeding, skull fractures, swelling, and pressure changes inside the skull. 
• MRI Scans: Magnetic resonance imaging provides highly detailed images of brain tissue, blood vessels, and areas damaged by hemorrhage or oxygen deprivation. MRI scans help doctors evaluate the extent of neurological injury and identify subtle bleeding that may not appear clearly on ultrasound or CT imaging. 
• Electroencephalogram (EEG): EEG testing measures electrical activity in the brain through sensors attached to the scalp. Some neonatal seizures are difficult to recognize without EEG monitoring because newborn seizure activity can appear subtle or intermittent. 
• Blood Testing and Laboratory Evaluation: Laboratory testing helps doctors identify medical conditions that may contribute to bleeding or worsen neurological injury. Blood tests may evaluate clotting function, infection markers, oxygen levels, blood sugar stability, and platelet counts.

After diagnosing a brain bleed, physicians continue monitoring for complications such as hydrocephalus, which occurs when cerebrospinal fluid builds up inside the brain’s ventricles. It may develop gradually over days or weeks following the initial hemorrhage. If pressure continues to rise, neurosurgeons may need to drain fluid or place a shunt to protect the brain from additional damage. 

Treatment Options for Infant Brain Bleeds

Treatment for an infant brain bleed depends on the location of the hemorrhage, the amount of bleeding, the infant’s gestational age, and the presence of complications such as seizures or hydrocephalus. 

• Monitoring and Supportive Care: Small hemorrhages that don’t increase pressure inside the skull may only need close observation and supportive treatment. Premature infants with low-grade intraventricular hemorrhages frequently undergo repeated cranial ultrasounds to track changes in bleeding or fluid buildup.
• Neonatal Intensive Care Unit (NICU) Treatment: Many infants with brain bleeds need treatment inside a NICU where doctors can provide continuous monitoring and life-support interventions. Newborns with severe hemorrhages may need respiratory support because neurological injury can interfere with normal breathing patterns.
• Seizure Management: Doctors typically begin anti-seizure medications as soon as seizure activity is confirmed or strongly suspected. Phenobarbital is one of the most commonly used medications in newborns, although physicians may use additional medications if seizures continue. Continuous EEG monitoring helps them evaluate how well treatment controls abnormal electrical activity inside the brain.
• Treatment for Hydrocephalus: Blood from a brain hemorrhage can block normal cerebrospinal fluid circulation and cause hydrocephalus. As fluid pressure rises, brain tissue becomes compressed and vulnerable to additional injury. In severe cases, neurosurgeons implant a ventriculoperitoneal shunt, commonly called a VP shunt, which redirects excess fluid away from the brain into the abdomen for absorption.
• Surgical Intervention: Surgery may become necessary when bleeding causes dangerous pressure inside the skull or fluid accumulation continues despite conservative treatment. Subdural hemorrhages involving large blood collections or severe intracerebral hemorrhages may require surgery if swelling threatens nearby brain structures.
• Respiratory and Cardiovascular Support: Infants with severe hemorrhages may need oxygen therapy, ventilators, or medications that support circulation. Maintaining stable oxygen delivery is a major part of treatment because additional oxygen loss can worsen neurological injury and increase the risk of permanent brain damage.
• Long-Term Rehabilitation and Therapy: Children who survive moderate or severe brain hemorrhages may require years of rehabilitation therapy.  Physical therapy helps children build strength, muscle control, posture, and coordination, while occupational therapy addresses fine motor skills and daily functioning. Speech therapy may help children with language delays, swallowing problems, and communication impairments.

Potential Long-Term Complications of Infant Brain Bleeds

Mild hemorrhages may heal without major complications, particularly when bleeding remains limited, and pressure inside the skull stays stable. Severe hemorrhages involving oxygen deprivation, hydrocephalus, or direct injury to brain tissue carry a much higher risk of developmental disability and chronic neurological conditions like:

• Cerebral Palsy: Grade III and Grade IV intraventricular hemorrhages have a substantially higher risk of cerebral palsy because bleeding and swelling can damage areas of the brain responsible for movement control. Early therapy may improve mobility and muscle function, but cerebral palsy remains a permanent neurological condition.
• Seizure Disorders and Epilepsy: Seizures vary in severity and frequency. Some children experience occasional, brief episodes controlled with medication. Others develop treatment-resistant epilepsy that interferes with learning, communication, sleep, and daily functioning.
• Developmental Delays: Motor delays are common after moderate and severe brain bleeds. Some children have trouble with balance, coordination, muscle control, and fine motor tasks such as grasping objects or feeding themselves. Speech and language delays may also appear if injury affects communication centers within the brain.
• Cognitive and Learning Impairments: Children who experienced neonatal brain hemorrhages may later develop cognitive impairments affecting memory, attention, reasoning, problem-solving, and academic performance. These difficulties sometimes become more noticeable during preschool or elementary school years when educational demands increase.
• Vision and Hearing Problems: Brain hemorrhages may damage areas responsible for visual and auditory processing. Some children develop partial vision loss, difficulty tracking movement, depth perception problems, or blindness after severe neurological injury. Hearing impairment may also occur if bleeding or oxygen deprivation damages auditory pathways within the brain. 
• Feeding and Swallowing Difficulties: Neurological injuries can interfere with the muscles and reflexes involved in swallowing and feeding. Some infants struggle with choking, aspiration, weak sucking, or the inability to coordinate swallowing safely. Children with severe feeding difficulties may require feeding tubes for nutritional support during infancy or long-term care. 
• Behavioral and Emotional Challenges: As children grow older, some develop behavioral difficulties linked to early neurological injury. Attention deficits, impulsivity, emotional regulation problems, anxiety, and social interaction difficulties may appear during school-age years.

For some families, the diagnosis also raises serious questions about the medical care provided during pregnancy, labor, delivery, or the newborn period. When preventable mistakes contribute to a brain hemorrhage, legal action may help families recover compensation for future medical treatment, therapy, and lifelong support needs.

Speak to a Michigan Birth Injury Lawyer Today

An infant brain bleed is a serious medical condition that can affect a child’s development, mobility, learning ability, and long-term health. Families caring for a child with a serious brain injury may face years of medical appointments, therapy sessions, rehabilitation treatment, educational planning, and long-term caregiving responsibilities.

If your baby suffered a brain bleed after a difficult pregnancy, labor complication, or traumatic birth, LegalGenius may be able to help you investigate what happened. Our birth injury lawyers work with medical experts to review fetal monitoring records, delivery documentation, imaging studies, and neonatal treatment timelines to identify possible negligence. For more information or to schedule a consultation, call 800-209-4000 or fill out our Ask the Genius™ form, and an attorney will contact you within five minutes. 

Frequently Asked Questions About Infant Brain Bleeds

Can an Infant Recover Fully From a Brain Bleed?

Some infants recover fully, particularly when the hemorrhage is small, and doctors identify the bleeding quickly. Grade I intraventricular hemorrhages may resolve without permanent neurological injury, especially in babies who remain medically stable after birth.  More severe hemorrhages can lead to permanent complications involving movement, learning, speech, hearing, or seizure control.

 Children with major brain injuries may require years of therapy, neurological care, and educational support. Doctors usually continue developmental monitoring throughout early childhood because some impairments become more noticeable as developmental demands increase.

Can Medical Negligence Cause an Infant Brain Bleed?

In some cases, yes. Failure to respond to fetal distress, delayed cesarean delivery, improper use of forceps or vacuum extractors, and delayed diagnosis after birth can increase the risk of preventable brain hemorrhages.

Medical records, fetal monitoring strips, imaging studies, and neonatal treatment notes may help determine if negligent care contributed to the injury. Families whose children suffered preventable neurological injuries may choose to pursue legal action to recover compensation for medical treatment and long-term care needs.

Can an Infant Brain Bleed Be Fatal?

Yes. An infant brain bleed can be fatal, particularly when the hemorrhage is severe, treatment is delayed, or the bleeding causes extensive damage to brain tissue. Large intracranial hemorrhages can increase pressure inside the skull, interfere with oxygen delivery, and damage areas of the brain responsible for breathing, heart rate regulation, and other vital functions.

Premature infants face the highest risk of life-threatening complications because their blood vessels are extremely fragile and their bodies may struggle to maintain stable oxygen levels and blood pressure after birth. Grade III and Grade IV intraventricular hemorrhages carry a much higher risk of death and permanent neurological injury than lower-grade bleeds. Severe subdural or intracerebral hemorrhages can also become fatal if swelling, seizures, or hydrocephalus are not treated quickly.

Sources

• National Center for Biotechnology Information. “The Diagnosis and Management of Intraventricular Hemorrhage in the Preterm Neonate.” PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC4967094/ 
• Cleveland Clinic. “Electroencephalogram (EEG).”  https://my.clevelandclinic.org/health/diagnostics/9656-electroencephalogram-eeg

Attorney Jeffrey Perlman

Attorney Jeffrey Perlamn is the managing partner at LegalGenius, PLLC. He has helped Metro Detroit accident victims recover the compensation they deserve for over 35 years. He believes everyone should have access to justice and the legal system, which is why Attorney Perlman spends his time outside of the courtroom writing informational blogs on the LegalGenius website that are accessible to all.