⚠️ BRAIN BLEED IS A MEDICAL EMERGENCY — CALL 108 or +91 9778280044 IMMEDIATELY
Emergency Neurosurgery · 24/7 · Hyderabad
Emergency Brain Bleed Evacuation in Hyderabad
Dr. Sayuj Krishnan provides 24/7 emergency neurosurgical care for intracerebral hemorrhage (brain bleeds), subdural hematomas, and epidural hematomas using endoscopic and minimally invasive techniques at Yashoda Hospital, Malakpet.
⚠️ When to Go to Emergency Instead of OPD
Call 108 or go to the nearest emergency room IMMEDIATELY if you or someone experiences:
Sudden Severe Headache
"Worst headache of my life" or thunderclap onset
Sudden Weakness
One-sided arm/leg weakness, facial droop
Speech Problems
Slurred speech, difficulty understanding others
Loss of Consciousness
Confusion, drowsiness, or fainting
Severe Vomiting
With headache and altered awareness
Seizures
New-onset seizure or convulsions
TIME IS BRAIN: Every minute counts in brain bleeds. Do NOT wait for symptoms to get worse. Go to emergency immediately or call for ambulance.
Understanding Brain Bleeds (Intracerebral Hemorrhage)
A brain bleed (intracerebral hemorrhage or ICH) occurs when a blood vessel ruptures inside the brain, causing blood to accumulate and create pressure on brain tissue. This is a life-threatening emergency requiring immediate neurosurgical evaluation.
The most common cause is uncontrolled high blood pressure, which weakens blood vessel walls over time. Other causes include head trauma, blood-thinning medications, aneurysms, arteriovenous malformations (AVMs), and cerebral amyloid angiopathy in elderly patients.
Early recognition and rapid treatment significantly improve survival and functional outcomes. Our emergency team at Yashoda Hospital provides 24/7 access to CT scanning, neurosurgical consultation, and immediate operative intervention when needed.
Emergency Evaluation Workflow
- Immediate triage and ABC (airway, breathing, circulation) stabilization
- Emergency CT brain scan within 15-30 minutes of arrival
- Neurosurgical consultation and treatment decision
- Blood pressure management and reversal of anticoagulation
- ICU admission with intracranial pressure monitoring if indicated
- Surgical evacuation for life-threatening bleeds
Surgical Treatment Options
Endoscopic Hematoma Evacuation
Minimally invasive endoscopic approach through a small burr hole allows us to evacuate the blood clot with minimal brain retraction. The HD endoscope provides excellent visualization while preserving healthy brain tissue. This technique reduces surgical trauma and accelerates recovery compared to traditional open craniotomy.
- • Small 2-3 cm incision
- • Reduced brain retraction
- • Faster recovery
- • Lower complication rates
Microsurgical Craniotomy
For large, superficial hemorrhages or when endoscopic access is not suitable, we perform microsurgical craniotomy using operative microscope and advanced neuromonitoring. This provides complete visualization and allows thorough hemostasis.
- • Best for superficial bleeds
- • Complete clot evacuation
- • Control of bleeding source
- • Decompressive effect
Minimally Invasive Catheter Drainage
For select deep bleeds, stereotactic catheter placement with thrombolytic agents can gradually dissolve and drain the clot. This is performed under image guidance with continuous monitoring in ICU.
Decompressive Craniectomy
When brain swelling is severe and life-threatening, removing a section of skull (craniectomy) provides emergency decompression. The bone flap is replaced 6-8 weeks later once swelling resolves.
ICU Care & Recovery
Neuro-ICU Phase (3-7 days)
Intensive monitoring of vital signs, intracranial pressure, and neurological status. Ventilator support if needed, blood pressure control, seizure prophylaxis, and early DVT prevention measures.
Rehabilitation (2-12 weeks)
Physical therapy, occupational therapy, and speech therapy as needed. Most patients transfer to inpatient rehabilitation facility for structured recovery program. Progressive mobilization and functional training.
Long-term Follow-up
Regular neurosurgical follow-up, MRI/CT imaging at intervals, blood pressure monitoring, and management of underlying causes. Vascular imaging to rule out aneurysm or AVM if appropriate.
Frequently Asked Questions
When is surgery needed for a brain bleed?
Emergency surgery is indicated when imaging shows significant mass effect, midline shift, or when the patient is deteriorating neurologically despite medical therapy. Small, deep bleeds may be managed conservatively with blood pressure control, reversal of anticoagulation, and close ICU monitoring.
What is endoscopic brain bleed evacuation?
Endoscopic evacuation uses a narrow tube with HD camera and specialized instruments to access the hematoma through a small burr hole. The technique minimizes brain retraction, reduces surgical trauma, and enables early rehabilitation compared to conventional craniotomy.
How long is the ICU stay after surgery?
Most patients require 3-7 days in neuro-ICU for ventilator support, intracranial pressure monitoring, and blood pressure management. Transfer to high-dependency or rehabilitation ward follows once vital signs stabilize.
What causes spontaneous brain bleeds?
Hypertension is the leading cause. Other contributors include cerebral amyloid angiopathy in elderly patients, anticoagulation therapy, aneurysm rupture, arteriovenous malformations, and underlying tumors. Imaging helps identify the cause.
Can brain bleeds be prevented?
Control hypertension, manage diabetes, limit alcohol, avoid smoking, and have regular monitoring if on blood thinners. Early intervention for aneurysms or AVMs identified on screening also reduces risk.
Dr. Sayuj Krishnan, Neurosurgeon
Room 317, OPD Block, Yashoda Hospital, Malakpet, Hyderabad, Telangana 500036
Phone: +91 9778280044 · Email: hellodr@drsayuj.info
Authored by: Dr. Sayuj Krishnan S, Neurosurgeon
Reviewed by: Dr. Sayuj Krishnan S, Board Certified Neurosurgeon
Last reviewed: 1 November 2025
Disclaimer: This content is for informational purposes only and should not replace professional medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment.
Medically reviewed by Dr. Sayuj KrishnanConsultant Neurosurgeon, Yashoda Hospital MalakpetLast reviewed 19 October 2025
This information is for educational purposes only and should not replace professional medical advice. Please consult with Dr. Sayuj for personalized medical guidance.