Dangerous micro bleeding even with minor head injuries

Dangerous micro bleeding even with minor head injuries

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Head injuries cause serious micro-bleeding in the brain

Even minor head injuries can lead to dangerous microbleeding in the brain. However, according to a current study, these can only be recognized by means of MRI scans, which is why they have so far mostly remained undetected in practice. For those affected, this poses a significantly increased risk of disability.

"Micro-bleeding can worsen the outcome of a head injury," reports the National Institute of Neurological Disorders and Stroke (NINDS). In a recent study, a research team at NINDS used MRI scans to identify microbleeding in the brain that could occur with minor head injuries. These were also associated with an increased risk of disability. The study results were published in the specialist magazine "Brain".

MRI examinations after head injuries

A total of 439 adults were considered in the current study who had to be treated for a head injury in the emergency room. "Participants underwent an MRI scan within 48 hours of the injury and again on four visits"; report the researchers. All participants also filled out behavior and result questionnaires.

Micro bleeding in just under a third of head injuries

The researchers were able to identify indications of microbleeding in 31 percent of the participants on the MRI images. The severe head injury affected more than half of the subjects (56 percent), while the minor head injury still affected more than a quarter (27 percent). "Traumatic micro-bleeding can represent damage to blood vessels that occurs after a minor head injury," emphasizes Dr. Lawrence Latour of NINDS.

Lesions can only be seen with MRI

The micro-bleeding appeared either as linear stripes or dotted lesions, with the majority of those affected with micro-bleeding having shown both variants, the research team reports. The most frequent occurrence was the micro-bleeding in the so-called frontal lobes of the brain and they were usually too small to be recognized with the help of computer tomography. This means that they usually go undetected and, in the worst case, there are serious health consequences.

Increased risk of disability from micro bleeding

Participants with micro bleeding were significantly more likely to be disabled and their severity than those without micro bleeding. "Although we know that damage to brain cells can be devastating, the exact effects of this vascular injury after a head trauma are uncertain and require further studies," emphasizes Dr. Latour.

Histological examination of the brain

In the current study, the research team also examined the brain of a deceased subject in-depth histologically and is trying to decipher how the micro-bleeding leads to further damage to the brain. "The results showed iron as an indicator of blood in macrophages (the brain's immune cells) that were tracked along the vessels on the first MRI scan, as well as in other broad areas," reports the National Institute of Neurological Disorders and Stroke.

Biomarkers for an increased risk

The research team concludes that microbleeding after brain injuries could serve as a potential biomarker to identify high-risk patients. In this way, it was possible to identify those affected, where treatment of the vascular injuries can make sense. (fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters


  • Lawrence L. Latour, et al .: Traumatic microbleeds suggest vascular injury and predict disability in traumatic brain injury; in: Brain (published October 14, 2019),
  • National Institute of Neurological Disorders and Stroke (NINDS): Microbleeds may worsen outcome after head injury (published 10/13/2019),

Video: Symptoms of Internal Head Injuries (June 2022).