Adele, the British singer posted on her blog unfortunate news that she has had to cancel her tour because of she has been diagnosed with a vocal fold hemorrhage.
Adele accurately described a vocal fold hemorrhage is, as a 'black eye' of the vocal fold. The vocal fold has many blood vessels within which normally are very small. A hemorrhage is when one of the vessels bursts causing blood to seep within the layers of the vocal fold. This can happen at a moment's notice as a result of voice overuse, screaming, or even after a violent cough. The blood weighs down the vocal fold, especially as it hardens, making it unable to vibrate properly. This causes voice changes and hoarseness. Vocal fold hemorrhages are bruises which take up to two weeks to fully resolve.
Complete voice rest is recommended during an episode of hemorrhage, as talking can cause more bleeding. Individuals are followed closely to ensure that the blood is completely absorbed before resuming voice use.
If one continues to use their voice during a period of hemorrhage, the vocal folds can scar causing permanent vocal fold damage. After resolution of the hemorrhage an individual is examined closely for any abnormal blood vessels which may be treated in-office with minimally invasive laser surgery.