Intracranial hematoma: what is it and how is it treated?

We refer to intracranial hematoma when we refer to the accumulation of blood within the bones that make up the skull. It is a serious situation that requires prompt medical attention.

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An intracranial hematoma is often life threatening. And although many others may be small, control of its evolution is imposed. It is not a subject to consider lightly, nor to let pass as one more symptom.

This problem develops when blood accumulates inside the skull bones. The locations of this blood collection are varied, and the clinical picture will change according to these positions.

One of the problems of these bruises is the pressure they generate on a sensitive organ such as the brain. That increased tension hurts neurons and complicates their function.

The mild form of intracranial hematoma is one that manifests with a concussion, that is, a brief loss of consciousness with complete recovery. However, serious forms can also occur leading to the death of the patient.

The accumulation of blood derives from a broken blood vessel inside the skull . This can be broken by trauma or by the spontaneous rupture of an artery, in cases of congenital malformations, for example.

Types of intracranial hematomas

According to its location within the skull, we speak of three types of intracranial hematomas.

Subdural hematoma

The subdural hematoma is located below the dura, which is one of the layers of the meninges . In the process, one or more blood vessels breaks, taking the blood collection to that region, where it is trapped. If the size is large, there is a serious risk to life.

When it is acute, the risk is greater . It is the one that, classically, appears immediately, after trauma. Symptoms do not wait and are usually quite evident, with loss of consciousness, nausea, seizures and pain.

Another variety is subacute subdural hematoma, which forms progressively, manifesting symptoms within days or weeks. And finally, the chronic subdural hematoma, which can last for months. The latter usually begins imperceptibly and develops silently.

Intracranial hematoma is the accumulation of blood within the skull. In serious cases, its outcome can be fatal.

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Epidural hematoma

This intracranial hematoma is located between the dura and the skull, in the outermost part of the brain, we could say. It is the closest blood collection to the outside.

The classic cause is trauma, and the complication is the inward pressure they exert . It is very common for patients with this variety to go through different stages of unconsciousness .

Intracerebral hematoma

Also known as an intraparenchymal hematoma. It is located within the brain tissue, in the middle of the neurons, and hence its name. It can originate from trauma, but also when strokes occur due to arterial ruptures or due to the presence of a congenital malformation.

Some brain tumors are also guilty of this clinical picture. Its treatment is more complicated because it involves a difficult position with serious risks of sequelae.

Intracranial Hematoma Treatment

When an intracranial hematoma is detected, its size and position are established. This is accomplished using imaging techniques such as CT or nuclear magnetic resonance.

If the intracranial hematoma is small, does not exert pressure, and the patient’s symptoms are stable, no specific treatment is instituted. Alarm guidelines are given and are usually rechecked after a period of time.

In larger, life-threatening cases, surgery is planned . In itself, the forms of the approach are two: localized drainage or craniotomy. With localized drainage, the aim is to influence the skull as little as possible.

To do this, a minimum hole is made in the skull shell to insert a probe through which the blood from the bruise drains out. In large injuries it is not possible to do so, and a craniotomy is used, with a frank opening of the bones.

Imaging tests such as CT and resonance guide the diagnosis.

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What to do when suspecting an intracranial hematoma?

If we have had a traumatic head injury, or suffer symptoms that make us suspect problems in the brain, the ideal is to consult immediately. As we said in the article, these are serious health problems that carry a vital risk.

Health professionals will perform complementary methods to determine the presence of an intracranial hematoma, know its size and position. Based on this, they can plan surgery, drainage or periodic check-ups.

Patients taking anticoagulant medications should pay special attention, since they are an aggravating factor for hematomas that worsen the condition. The doctor who cares for these patients should know from the first moment that these drugs are being consumed.

A timely consultation can save life; therefore, it is essential not to delay care in these cases. Intracranial hematoma is a medical emergency and must be addressed as such.


by Abdullah Sam
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