What to Know About a Blood Clot in the Brain

A blood clot in the brain can have serious consequences. Blood clots may form in arteries or veins of the brain. A blood clot in a vein in the brain is often called cerebral venous sinus thrombosis. This is a type of stroke that can cause permanent brain damage.

Most strokes are caused by an interruption of blood flow in an artery of the brain. Cerebral venous thrombosis is not as common as a blockage of arterial blood flow. The causes and risk factors of cerebral venous thrombosis include conditions or medications that increase the body’s tendency to form blood clots.

This article describes the symptoms, risk factors, diagnosis, treatment, and what to expect if you have a cerebral venous thrombosis.

Emergency Symptoms of a Blood Clot in the Brain 

A blood clot in the brain can cause sudden neurological symptoms and head pain. Usually, the head pain associated with a blood clot in the brain is intense and develops abruptly. It’s often described as “the worst headache of my life.”

The neurological symptoms correspond to ischemia (lack of blood supply) in the brain.

Some differences between symptoms of a blood clot in a vein or an artery are:

• A headache is the most common symptom of cerebral venous thrombosis.
• Neurological symptoms are not common with cerebral venous thrombosis.
• With cerebral venous thrombosis, the ischemia affects both sides of the brain. If neurological symptoms develop, they may affect both sides of the body.
• When blood flow is blocked in an artery, it usually affects one side of the brain, with symptoms experienced on the opposite side of the body.

Symptoms of a blood clot in the brain can include:

• An intense headache
• Blurred vision, loss of vision, or other vision changes
• Weakness of one side of the body, affecting the arm, leg, or both
• Slurred speech
• Drooping mouth or eyelids on one side of the face
• Difficulty finding words or understanding what other people are saying
• Confusion
• A seizure (an episode of uncontrolled and erratic electrical activity in the brain)
• Changes in consciousness
• Numbness or tingling on one side of the body
• Inability to walk
• Impaired balance and coordination

Usually, a blood clot in the brain causes one or more of these symptoms, but it doesn’t usually cause all of them.

Risks of Delayed Blood Clot in Brain Treatment 

Any type of blood clot in the brain can cause severe brain damage, resulting in permanent disability. Arteries supply the brain with oxygen and nutrient-rich blood. When the blood supply is interrupted, ischemia results in brain cell death.

When a blood clot affects a large artery or vein in the brain, a substantial area of the brain can be affected. With large vessel blood clots, extensive swelling in the brain can develop, and it may be life-threatening.

A stroke of any type, including a cerebral venous thrombosis, is a medical emergency that requires prompt medical intervention. Without timely diagnosis and treatment, brain damage and swelling may continue to worsen over the course of hours.

Treatment can help stabilize a person who is having a stroke and can sometimes prevent a stroke from progressively damaging the brain.

At the ER: Treating a Blood Clot in Brain 

If you go to the emergency room with a possible blood clot in the brain, here is what you can expect:

• A neurological examination that the healthcare provider will use to identify signs of a stroke
• Assessment of your vital signs, which includes blood pressure, pulse, temperature, and respiratory rate
• A brain imaging test if there’s a possibility of a stroke
• Treatment to stabilize vital signs, including blood pressure control
• Intravenous fluids, as needed
• Intravenous blood thinners to prevent the blood clot from enlarging
• An interventional procedure that can help dissolve or remove a blood clot

Before you arrive at the emergency room, it’s highly likely that a stroke team will be on call to begin evaluating your risk factors and to determine whether it is safe for you to have blood thinners or an interventional procedure.

Some people are unable to receive blood thinners or undergo a procedure due to a high risk of bleeding or other medical risk.

What Caused a Brain Clot to Form?

Several risk factors can contribute to blood clots in the brain. The risk factors that cause an arterial stroke include heart disease, high blood pressure, high cholesterol, diabetes, and vascular disease.

A cerebral venous sinus thrombosis has risk factors that differ from those of an arterial stroke. These blood clots are described as occurring in a “sinus” such as the dural sinus or the sagittal sinus. This type of sinus is a large vein in the brain—it is not the same as your respiratory sinuses that can become congested when you have a cold or allergies.

Some risk factors may include:

• Blood disease or immunological disease that raises the risk of blood clots, such as lupus or factor five Leiden deficiency
• Pregnancy, especially high-risk pregnancy
• Certain medications, particularly hormonal therapies containing estrogen
• A family history or a personal history of blood clots at a young age
• Cancer or chemotherapy
• Head trauma
• Recent brain surgery

Hospitalization Time With a Blood Clot in Brain

The hospitalization time with a blood clot in the brain varies. Hospitalization may also be followed by inpatient or outpatient rehabilitation. Depending on the extent of damage and the effects of treatment, hospitalization may range from several days to a week or longer.

Factors that may prolong hospital stay include:

• More than one blood clot in the brain
• Edema (swelling and fluid) in the brain
• Having a seizure
• Bleeding in the brain or any other area of the body, such as gastrointestinal (stomach and intestines) bleeding
• Unstable medical condition, which may include fluctuating blood pressure or blood sugar
• Complications such as pneumonia (lung inflammation), a blood clot in the legs, or a blood clot in the lungs
• Other medical problems, such as a heart attack occurring within a few days of the blood clot in the brain

Even after you are medically stabilized and able to go home, you will need medical follow-up within the first few weeks. You may also need an evaluation to identify the risk factors that could have led to your blood clot. Treatment for those risk factors will be initiated. You may need periodic medical surveillance to monitor the effects of your treatment.

Rehabilitation After Cerebral Blood Clot 

After recovering from a blood clot in the brain, you might need ongoing rehabilitation. This can include exercises to build strength, balance, and speaking and swallowing abilities. You might also need to relearn or adjust to self-care skills.

Your rehabilitation will be individualized for you, depending on what types of impairments you may have developed due to the blood clot. It’s important to understand that rehabilitation takes time and that most people experience a slow and beneficial improvement with rehabilitation.

You can work with your therapy team to assess your abilities and follow your improvement. You will likely be given a program that involves a stepwise progression, with increasing levels of difficulty throughout your rehabilitation.

Often, rehabilitation for severe strokes or brain damage from cerebral venous thrombosis may begin in an inpatient rehabilitation facility. With inpatient rehabilitation, you may receive assistance with daily tasks, such as using the toilet, bathing, or eating—as needed.

You will also have your vital signs checked regularly, and you may need some medication adjustments during this phase of your recovery.

As you become more independent, you will be able to go home. You may continue to receive home visits from healthcare professionals, who will provide additional physical therapy exercises and check to see how you are progressing.

Your family members or other caregivers would be instructed on how to help you with your daily tasks as needed.

Adapting to Lifestyle Changes

Many people can experience significant recovery after a blood clot in the brain. You might be able to go back to the activities you enjoyed before your blood clot. However, you might have to make some adjustments if you still have some level of disability.

Adjustments that you may need to make could include the following:

• Using a walker or cane to get around safely if you have problems with balance, dizziness, or coordination
• Adjusting your diet so that you eat and drink things that do not pose a high risk of choking
• Using a splint or a brace on your foot or arm if you have developed low muscle tone (floppiness) of any of your extremities
• Using muscle relaxant medication if you’ve developed spasms of your muscles
• Getting an evaluation regarding your ability to drive if your vision has been impaired
• Taking medication to prevent seizures if you have developed a seizure disorder due to the blood clot
• Taking medication to control pain if you have developed chronic or persistent head pain

You may need periodic reevaluations. You should expect to experience some changes with time, so you will require adjustments in your lifestyle routines.

For example, many people have floppy tone in their muscles shortly after a stroke, but this can evolve into spasticity (abnormal muscle tightness) as time goes on. Similarly, if you take medication for head pain, the pain may go away after some time, and you might not need the medication anymore after a while.

Summary 

Blood clots in the brain can occur in a vein or an artery. Both of these are types of strokes, but a blood clot in a vein in the brain is usually referred to as a cerebral venous sinus thrombosis, and a blood clot in a brain artery is commonly referred to as a stroke.

There are many risk factors for these types of blood clots. A blood clot in a vein of the brain can occur due to blood clotting disorders or risk factors that increase the likelihood of blood clots.

Any blood clot in the brain is a medical emergency that requires prompt medical evaluation and treatment. Interventions can help prevent long-term effects and can save your life. If you experience any neurological symptoms or sudden head pain, seek medical attention right away.

Recovery after a blood clot in the brain can take months or years, and you should expect a gradually progressive improvement over time.