Hello! Coumadin is an anticoagulant wich is used as a precaution in diseases thart have high risk of artery embolism or venous thrombosis. Persons who take this drug have a high tendency to bleeding, even from small traumas. It has to be stopped immediately if the patient has active bleeding (even not caused by traumas) There are 4 types of acute bleeding in the brain after a head injury, wich can be accompanied by skull fractures or not. Epidural hemorrhage, is the collection of blood between the dura (the outer layer of the brain) and the skull, forming a lens -shaped hematoma. It is caused by the rupture of the middle meningeal artery and is usually due to temporal bone fracture. At first the patient may be lucid and have no signs, but with the rapid collection of the blood the situation become dramatical soon. Since the blood flows from a artery it is a very dangerous condition and it is treated surgically. Subdural hematoma, is the collection of blood between two of brain layers (dura and arachnoid). The cause is the rupture of the bridging veins. It forms a crescent shaped hematoma. Subarachnoid hemorrhage is ccaused by bleeding into the cerebrospinal fluid from damaged blood vessels. Between the Arachnoid and pia lay important brain arteries. This is associated with severe headche because of the irritation that blood causes to the meninges. Intracerebral hemorrhage (the bleedin inside the brain tissue) wich is called contusion. It may vary from small areas of bleeding in the white matter to larger colection of blood. I hope your niece will be better soon. Kind regards