What Is Intracranial Hematoma?
An intracranial hematoma is a pool of clotted blood that is formed within the skull after a traumatic injury. It is most commonly caused by a ruptured blood vessel that bursts in the brain. It may also be caused by a traumatic injury such as a car accident or a free fall. The blood may either get collected in the tissues of the brain or underneath the skull, thereby putting pressure on the brain. Some head injuries are minor that cause only a small period of unconsciousness. However, the condition of intracranial hematoma is potentially life-threatening and usually requires immediate and quick treatment. Surgery also might be required to remove the blood.
How Is Intracranial Hematoma Classified?
Intracranial hematomas can be classified according to the onset and volume of intracranial bleeding. An acute hematoma is usually life-threatening, and emergency treatment is required immediately. A chronic hematoma, on the other hand, is less immediately dangerous, but treatment should be necessitated to minimize the impact on cognition. It is crucial to treat chronic hematoma because it will partially restore the brain's functions and may prevent further deterioration of the brain tissues.
Intracranial hematomas are also sometimes classified based on their location:
1. Epidural Hematoma - An epidural hematoma is formed between the skull and the dura mater. Only a few people sustaining this type of injury remain conscious. Most of them become drowsy, lose consciousness, and may even go into a state of coma from the moment of traumatic injury. Prompt treatment is required in case of an arterial injury to the brain.
2. Subdural Hematoma - A subdural hematoma occurs between the dura mater and the brain. It is caused due to rupturing of the blood vessels between the brain and the outermost three protective meningeal layers covering the brain (dura mater). The blood that is leaked forms a hematoma that presses on the tissues of the brain. As the hematoma grows larger, it can lead to gradual loss of consciousness and, in some cases, death. There are three types of subdural hematomas:
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Acute Subdural Hematoma- This is the most dangerous type of hematoma and generally occurs due to a severe head blow or injury. The signs and symptoms usually appear immediately, and it requires immediate treatment.
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Subacute Subdural Hematoma- In this type of hematoma, the signs and symptoms usually take some time to develop, from days to weeks after the head injury.
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Chronic Subdural Hematoma- This type of hematoma results from less severe traumatic head injuries and can cause slow bleeding. The symptoms can appear within a few weeks to months. Bumping the head while getting into the car is an example of a chronic type of hematoma that can cause bleeding, especially if the individual takes blood-thinning medication.
Medical aid is required for all three types of hematomas as soon as the signs and symptoms appear in order to prevent permanent brain damage.
3. Intraparenchymal Hematoma- An intraparenchymal hematoma is formed inside the brain and is sometimes referred to as an intracerebral hematoma. This type of hematoma occurs when blood pools in the brain tissues. Numerous causes include trauma, aneurysms, poorly connected arteries, and veins congenitally, increased blood pressure, and even brain tumors. The blood can spontaneously leak into the brain. Multiple severe intracerebral hematomas can result from several head injuries.
What Are the Risk Factors for Intracranial Hematoma?
Intracranial hematomas usually occur due to moderate or severe injuries to the head, such as injuries that are caused after being sustained during a motorbike or bicycle accident, a vehicle accident, a free fall, or an act of violence.
Some people are more prone to developing intracranial hematomas even after sustaining minor head injuries, especially subdural hematomas. Individuals who are particularly at higher risk of developing intracranial hematomas include those:
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Above the age of 60 years.
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Abused by excessive alcohol consumption.
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Individuals consuming blood-thinning medicines like Aspirin or Warfarin.
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Individuals who experience head trauma repeatedly.
What Are the Causes of Intracranial Hematoma?
An injury to the head is the most common cause of bleeding within the cranium. A traumatic injury to the head may result from a motorbike or bicycle accident, falls, assaults or fights, and a few sports injuries. Even a very mild head trauma can cause a hematoma if the affected person is an elderly person. A serious injury can occur even if there is no open wound or injury, bruise, or other brain damage.
What Are the Signs and Symptoms of Intracranial Hematoma?
As the pressure on the brain increases, some or all of the following signs and symptoms are produced:
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Severe headache that worsens with time.
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Nausea and vomiting.
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Drowsiness and temporary loss of consciousness.
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Feeling faint.
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Mental confusion.
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Pupil size is unequal on both sides.
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Speech is not clear.
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Paralysis on the opposite side of the body from the traumatic brain injury.
As the hematoma grows in size, other signs and symptoms may also appear, such as:
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Laziness.
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Epileptic seizures.
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Loss of consciousness.
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Irritability.
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Sweating.
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Weakness and unsteadiness.
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Difficulty in walking.
How Is the Diagnosis of Intracranial Hematoma Made?
The diagnosis of an intracranial hematoma is established on the basis of a thorough physical examination and certain imaging tests. The doctor should obtain a complete medical history of the patient and family. The doctor may order certain diagnostic scans such as:
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Computed Tomography Scan- A computed tomography scan demonstrates detailed images of the bones, muscles, fat, and various body organs. These scans use X-rays.
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Magnetic Resonance Imaging Scan- It is also used to produce detailed images of various structures within the body.
What Is the Treatment of Intracranial Hematoma?
Treatment depends on the extent of the severity of the hematoma and the presence of other injuries. Management may include:
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Stitches to close the wound.
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Patient hospitalization for observation.
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Brain surgery to drain blood and remove the clot.
The pressure inside the skull increases due to swelling of the brain, which can lead to brain damage. A patient suffering from severe head injury should be monitored to manage increased intracranial pressure. If the pressure increases, immediate medical and surgical treatment should be provided.
How to Prevent Head Injury?
To prevent head injury,
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Always wear a helmet while riding a motorbike or bicycle. Make sure that children are also wearing helmets.
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Seat belts should be buckled.
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Protect young children from climbing stairs and use properly fitted car seats.
Conclusion:
Intracranial hematoma is a life-threatening condition that requires emergency treatment. One should seek quick medical aid after a severe blow to the head or in case of brain injury. Prevention is better than cure. So necessary precautions must be taken for children to avoid such mishappenings.
