Intracranial hematoma

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Intracranial hematoma is the most severe consequence of a head injury. Extravasation of blood may occur in the area of ​​the brain tissue, then we are dealing with an intracerebral hematoma, the symptoms of which do not differ much from a contusion of the brain, except for a more turbulent course and a higher risk of complications.

Intracranial hematoma

Extravasation of blood (intracranial hematoma) can take place in the area of ​​the brain tissue, then we are talking about an intracerebral hematoma, which has a more turbulent course than a contusion of the brain. In addition, extravasation can also occur between the outer and inner lamina of the dura mater (epidural hematoma) or under the dura mater (subdural hematomaThese two types of hematoma are often called together cerebral hematomadiffer in the origin of the extravasated blood. In epidural hematoma, blood comes from a ruptured arterial vessel, while in subdural hematoma from venous vessels.

In the characteristic course of a cerebral hematoma, stages of consciousness disturbance are distinguished immediately after the injury, and then period of the so-called clearin which the patient regains consciousness and has no symptoms of brain damage, and a period of increasing neurological symptoms, both focal, e.g. in the form of paresis, and general, with increasing disturbances of consciousness up to coma.

The rate at which a hematoma develops may vary depending on the size of the type of vessel that is broken. In the most dangerous cases, large amounts of blood may extravasate in minutes, or accumulate very slowly, lasting several weeks or even months. In the first case, there is a high risk of the patient’s death, in the second, headaches and mental disorders often develop slowly, only after a few weeks or months after the injury, which the patient does not remember or ignore.

Types of intracranial hematomas

Intracranial hematomas are classified into those that cause bleeding in the brain itself and those that cause hemorrhage inside the skull but outside of the brain tissue. In the classification of intracranial hematomas, we distinguish:

1. Epidural hematoma – it is a blood extravasation to the space between the skull bone and the dura mater, which is a complication of approx. 10%. head injuries. The amount of blood in the epidural space gradually increases, causing pressure to be exerted on the brain, resulting in rupture of the meningeal artery. Epidural hematoma is characterized by the fact that the patient initially loses consciousness, then recovers for several hours and faints again. Clinical symptoms appear after a few minutes or hours. Although the hematoma may lead to death, it is quickly diagnosed and treated and has a good prognosis. In addition, symptoms such as:

1. nausea,
2. vomiting,
3. dilatation of the pupil (on the side of the hematoma),
4. paresis of half of the body, which may be preceded by convulsions,
5. skull fracture in the temporal-parietal region.

Patients with known epidural hematoma should undergo immediate surgery to avoid cerebral coma. Surgical treatment is needed in about half of all cases, but sometimes the hematoma is small and it is enough to take medications preventing the build-up of intracranial pressure.

2. Subdural hematoma – is caused by the accumulation of venous blood between the dura mater and the arachnoid. This condition can rupture veins in the brain, and can be caused by severe head injuries, especially those where the bones of the skull are fractured. Symptoms of subdural hematoma are very diverse and depend on the location of the lesion. In patients, the following are observed: speech disorders, headaches, walking problems, somnolence, epilepsy and disturbed consciousness.

Surgical treatment is necessary. Another consequence of a contusion of the brain may be subarachnoid hemorrhage, in the course of which there is a hemorrhage between the soft dura and the arachnoid. Haemorrhage is manifested by pain in the back of the head, vomiting, convulsions, neck stiffness, and loss of consciousness.

3. Intracerebral hematoma – otherwise known as a hemorrhagic stroke, it is characterized by the accumulation of blood around the brain, especially at the base of the frontal and temporal lobes. Intracerebral hematoma located in the cerebellum is very dangerous, as it exerts pressure on the respiratory center of the brainstem, which poses a threat to the patient’s life.

Diagnostics of the intracranial hematoma

The diagnosis of intracranial hemorrhage is based on the examination in the form of computed tomography, and in case of doubt, magnetic resonance imaging. Large hematomas require immediate surgical treatment because they increase intracranial pressure and the movement of brain structures beyond its limits, which causes its damage. In addition, high blood pressure not only restricts blood flow to the brain, it can also damage delicate tissue in it. In extreme cases, death occurs.

Intracranial hematoma – prevention

In prevention, it is most important to minimize the risk of head injury. For this reason, it is very important to take care of children’s safety, as well as yours. However, it is during childhood that the most accidents and head injuries occur, which leave behind a memento in the form of a tumor. Here are some practical tips to help you avoid trauma and therefore intracranial hematoma:

– when riding a bicycle, skateboard, ice skating or horseback riding, always remember to put on a protective helmet for your child and yourself; the helmet can protect the head against possible injuries after a fall;

– remember about the seat belts both for you and your children; thanks to this you will minimize or prevent the risk of head injuries in a car accident;

– take care of your child’s safety; you are not able to protect him from minor accidents, but you can, at least through proper care, minimize the risk.

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