The dangerous ailment that Jamie Foxx says was almost missed

Academy award-winning actor, comedian and musician Jamie Foxx has revealed that a brain bleed that caused a stroke was the cause of his 2023 hospitalization. In his Netflix special, Foxx tells the story. He says in April 2023, he developed a severe headache and asked for a pain reliever. Then, he passed out. The first doctor he saw gave him a cortisone shot and sent him home. Foxx's sister was still worried about him and took him to a hospital, where another doctor recognized that Foxx had suffered a stroke.

In this Q&A, Ghada Mohamed, M.D., a stroke neurologist at MUSC Health, talks about what a brain bleed is, what signs to watch out for, when to take a pain reliever versus when to call 911 and why “time is brain” when it comes to strokes.

Q: What is a brain bleed?

A: A brain bleed is the rupture of one of the vessels, causing leakage of blood into the brain. There are two types of stroke: either a blood clot that blocks the blood vessel or a blood vessel ruptures and the blood leaks out. When the blood leaks out, that can cause cell damage and can cause other things like brain swelling and brain herniation if it was massive bleed.

Q: What are the warning signs of a brain bleed?

A: A sudden, severe headache is one of the warning signs, especially if it's a new type of headache that the patient is not used to. Also, watch for things similar to the signs of strokes: acute balance issues, acute vision change, double vision, loss of vision, severely blurry vision facial droop, arm weakness, slurred speech and inability to talk, especially if it's associated with an increase in blood pressure. 

We see high bleeds in patients with uncontrolled hypertension or patients with blood pressure that spikes so fast and so high that it can cause the rupture of the brain vessels. Sometimes, the patient becomes acutely confused and becomes comatose. But the most common sign is a sudden severe headache, along with the regular stroke signs.

Q: How can you tell if it’s just a bad headache versus something more serious?

A: If a patient normally has headaches, like migraines, morning headaches, that's their normal. But if the patient develops an acute, severe headache that is not usual for them, like a bad headache, a persistent headache, especially if it's associated with any neurological deficit – if it's associated with blurry vision, facial droop weakness or speech – they have to seek immediate medical attention. 

Q:  Stroke doctors use the phrase “time is brain.” What does that mean?

A: "Time is brain" means each minute counts to save brain cells. That's why we have to act fast for patients with strokes. So for patients with stroke due blood clots, the time is important because there is a window to give the thrombolytic therapy [medication that dissolves blood clots], which is four-and-a-half hours. So each minute counts. 

And same thing for the brain bleed. If the patient does not get medical attention immediately, there is a risk of expansion of the bleed and damage of more brain cells. So each minute, brain cells are dying and each minute counts to save those brain cells.

Q: Do you think having a famous figure such as Jamie Foxx talk about his experience will help raise awareness?

A: Education is important for public awareness. If you have a celebrity, people may be following their news. They may read the story and learn about the signs. They might also Google "brain bleed" and get some information about what the signs are.

Q: What message do you want to leave people with?

A: For patients with high blood pressure, they really need to keep it under control. Because that's No. 1 cause of brain bleed. The other thing is, patients with family history of brain bleeds, especially if it's related to aneurysm, they might need to seek medical attention just to do some surveillance imaging to make sure that they don't have an aneurysm. If they have family history of aneurysms and ruptured aneurysms. It's not for everybody, but it’s important for people with family history.