An intracranial hematoma occurs when a blood vessel ruptures within your brain or between your skull and your brain. The collection of blood (hematoma) compresses your brain tissue.
An intracranial hematoma may occur because the fluid that surrounds your brain can't absorb the force of a sudden blow or a quick stop. Then your brain may slide forcefully against the inner wall of your skull and become bruised.
Although some head injuries — such as one that causes only a brief lapse of consciousness (concussion) — can be minor, an intracranial hematoma is potentially life-threatening and often requires immediate treatment.
An intracranial hematoma often requires surgery to remove the blood. However, a smaller intracranial hematoma may not require surgery.
Signs and symptoms of an intracranial hematoma may be evident immediately after a blow to your head, or they may take several weeks or longer to appear. You may seem fine after a head injury, a period called the lucid interval. However, with time, pressure on your brain increases, producing some or all of the following signs and symptoms:
As more and more blood fills your brain or the narrow space between your brain and skull, other signs and symptoms may become apparent, such as:
When to see a doctor
Seek immediate medical attention after any significant blow to the head in which:
Although symptoms of intracranial hematoma may not be immediately apparent, watch closely for subsequent physical, mental and emotional changes. For example, if someone seemed fine after a blow to the head and could talk, but then lapsed into unconsciousness, seek immediate medical care.
In addition, even if you feel fine, tell someone you've experienced head trauma and ask him or her to keep an eye on you. Memory loss often is associated with head trauma, so you may forget that you had a blow to the head. An alerted friend, family member or work colleague may be more likely to recognize the warning signs and arrange for prompt medical attention.
The cause of intracranial bleeding (hemorrhage) is an injury to the head, often as a result of an automobile or motorcycle accident or even a seemingly trivial event, such as bumping your head. Mild head trauma is more likely to cause a hematoma if you're an older adult, especially if you're taking an anticoagulant or anti-platelet drugs, such as aspirin. A serious injury may have occurred even if there's no open wound, bruise or other outward sign of damage.
If a hematoma results from the injury to your head, it may occur as a subdural hematoma, an epidural hematoma or an intraparenchymal hematoma.
The three types of subdural hematomas include:
All three types require medical attention as soon as signs and symptoms are apparent, or permanent brain damage may result.
The risk of subdural hematoma is greater for people who:
Some people with this type of injury may remain conscious, but most become drowsy or comatose from the moment of trauma. An epidural hematoma that affects an artery in your brain can be deadly unless you get prompt treatment.
The trauma that causes intraparenchymal hematomas often is responsible for so-called white matter shear injuries — torn axons in the brain's white matter. Axons are connections that carry electrical impulses, or messages, from the neurons in the brain to the rest of the body. When this connection is sheared, serious brain damage can result because the neurons can no longer communicate.
Trauma isn't the only cause of intraparenchymal hematoma. Nontraumatic causes, which are rare, may include:
A blow to the head can lead to an intracranial hematoma. If the injury occurs between your brain and the outermost of three membrane layers that cover your brain (dura mater), it's known as a ...
Tests and diagnosis
Diagnosing an intracranial hematoma can be difficult because individuals may seem fine after an injury. However, doctors generally presume that the progressive loss of consciousness after a head injury is caused by a hemorrhage inside the skull until proved otherwise.
Imaging techniques are the best ways to define the position and size of a hematoma. These include:
Treatments and drugs
Some subdural hematomas don't need to be removed because they're small and produce no signs or symptoms. Diuretic medications may help control brain swelling (edema) after a head injury.
Recovery after an intracranial hematoma can be prolonged and may be incomplete. In adults, most recovery takes place within the first six months after the injury. Children usually recover faster and more completely than adults do.
Coping and support
Patience is the key to coping with brain injuries. Adults will experience the majority of their recovery during the first six months. You may continue to experience smaller, more gradual improvements for up to two years after the hematoma.
The following tips may help make for a smoother recovery:
These steps may help to prevent or minimize head injury:
Last Updated: 2011-06-25
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