Intracranial hematoma: causes, symptoms, diagnosis and treatment

An intracranial hematoma is an accumulation of blood inside the skull. It is usually due to the rupture of a blood vessel in the brain. It can also result from trauma such as a car accident or a fall. Blood can pool in the brain tissue or under the skull and put pressure on the brain.

Some head injuries, such as those that only result in a brief period of unconsciousness, can be minor. However, an intracranial hematoma can be fatal. It usually requires immediate treatment. This could include surgery to remove the blood.

Signs and symptoms of an intracranial hematoma may appear immediately after a head injury or may take several weeks or longer to appear. After sustaining a head injury, you may appear to be fine. This period is called the lucid interval.

However, over time, the pressure in the brain increases, causing some or all of the following signs and symptoms:

Worsening headache Vomiting Drowsiness and progressive loss of consciousness Dizziness Confusion Pupils of unequal size Slurred speech Loss of movement (paralysis) on the side of the body opposite the head injury

As blood flows to the brain or the space between the brain and the skull, other symptoms may develop, such as:

Lethargy Convulsions Unconscious

An intracranial hematoma can be fatal and requires emergency treatment.

Consult a doctor immediately after a blow to the head if the following occurs:

You lose consciousness You have a persistent headache You have vomiting, weakness, blurred vision, unsteadiness

If you don’t notice signs and symptoms immediately after being hit on the head, watch for physical, mental, and emotional changes. For example, if someone seems fine after a head injury and can talk, but then loses consciousness, seek medical attention immediately.

Even if you feel fine, have someone watch you. Memory loss after a blow to the head can cause you to forget the blow. Someone you’ve told about the stroke is more likely to recognize the warning signs and seek immediate medical attention.

Diagnosing an intracranial hematoma can be difficult because people who have a head injury may appear to be fine. However, doctors often assume that bleeding into the skull is the cause of progressive loss of consciousness after a head injury until proven otherwise.

Imaging techniques are the best ways to determine the position and size of a bruise. These include in particular the following:

computed tomography .

A sophisticated X-ray machine linked to a computer is used to produce detailed images of the brain. In this study, you remain motionless, lying on a movable table which is inserted into a machine similar to a large doughnut in which the images are produced. There

computed tomography

It is the most frequently used imaging technique to diagnose intracranial hematomas.

Magnetic resonance.

This is done using a magnetic field and radio waves to generate computerized images. during

magnetic resonance

you lie down on a mobile table inserted in a tube.

Angiography.

If a possible brain aneurysm or other blood vessel problem is suspected, an angiogram may be needed to provide more information. This test uses X-rays and a special dye to produce images of blood flow through blood vessels in the brain.

Bruises that are small and cause no signs or symptoms do not need to be removed. However, signs and symptoms may appear or worsen days or weeks after the injury. As a result, you may be monitored for neurological changes, have your intracranial pressure measured, and have various CT scans of the head.

If you are taking blood thinners, such as warfarin (Coumadin, Jantoven), you may need treatment to reverse the effects of the drug. This will reduce the risk of further bleeding. Options for reversing the effect of blood thinners include administration of vitamin K and fresh frozen plasma.

Treatment for bruises often involves surgery. The type of surgery depends on the type of bruise you have. Here are some options:

surgical exudate.

If the blood is in an area and has changed from a solid clot to a liquid, the doctor may create a small hole in the skull and use suction to remove the liquid.

Craniotomy.

Large bruises may require opening a section of the skull (craniotomy) to remove blood.

Recovery after suffering from an intracranial hematoma can take a long time and you may not fully recover. Recovery can take up to three months from the time of injury; after that there is usually a minor degree of improvement. If you continue to have neurological problems after treatment, you may need physical and occupational therapy.