When blood begins to collect within the skull it is called intracranial hematoma. However, the blood may collect underneath the skull or in the brain tissues, which puts pressure on the brain. This condition usually occurs due to a blood vessel that bursts in the brain or head injuries caused by falls or car accidents.
Sometimes, head injuries are not dangerous such as when they cause temporary unconsciousness. Generally, this is a life-threatening condition that requires immediate treatment. The most common treatment recommended by doctors is surgery to remove the blood.
Symptoms
While some people experience intracranial hematoma symptoms right after a head injury, others may have symptoms after several weeks or more. That period of time without symptoms after a head injury is called a lucid interval. However, pressure on the brain increases over time, which may cause any of the following symptoms. For example:
- Headaches
- Vomiting
- Dizziness
- Confusion
- Drowsiness
- Loss of consciousness that occurs gradually
- Speaking problems
- Different pupil sizes
- Paralysis (loss of movement)
However, when the blood fills or narrows the space between the skull and brain, the following symptoms may appear. For example fatigue, seizures, and loss of consciousness.
Seek emergency care if you suspect you have intracranial hematoma or experience the following symptoms after a head injury. These include loss of consciousness, persistent headache, vomiting, dizziness, or blurred vision.
However, it is recommended to visit a doctor even if you do not have any symptoms after a head injury to make sure the blood is not collecting in the brain or skull.
Causes
In most cases, intracranial hematoma happens due to a head injury that causes bleeding within the skull. People get head injuries from motor vehicle or bicycle accidents, falls, assaults, and sports.
Furthermore, older people are more likely to experience hematoma even if the head trauma is mild, especially if they use anticoagulants or anti-platelet medicines (such as Aspirin).
Intracranial hematoma may occur even if there are no open wounds, bruises, or other damage you can see. In addition, things that happen in the brain depend on the hematoma type you experience. There are 3 categories of hematoma including subdural hematoma, epidural hematoma, and intracerebral hematoma (also known as intraparenchymal hematoma).
Subdural Hematoma
This type of hematoma happens when a blood vessel bursts between the brain and the first 3 protective layers that cover the brain. These layers are called the dura mater. After that, the blood begins to collect making a hematoma. Sudden treatment is required in such cases because it may cause loss of consciousness and even death. Check below some types of subdural hematomas:
- Acute – It is the most dangerous type of subdural hematoma. The symptoms usually appear suddenly when a head injury occurs.
- Subacute – The symptoms appear usually within several weeks in such cases.
- Chronic – It occurs when the head injury is not serious. This hematoma type causes slow bleeding and symptoms often appear within a few months.
It is advised to visit a doctor no matter if that subdural hematoma occurs. If you get treatment right after a head injury, it may prevent long-term damage to the brain.
Epidural Hematoma
It occurs when a blood vessel bursts between the dura mater and the skull. Thus, the blood begins to leak between previous head structures and may form a mass that puts pressure on the brain. Commonly, people experience epidural hematoma due to head injuries.
While most people with epidural hematoma (also known as extradural hematoma) experience drowsiness and come (sometimes), others remain conscious. If you do not receive treatment for this hematoma type it may cause permanent brain damage and even death.
Intracerebral Hematoma
This is the third type of hematoma in which blood pools appear in the brain tissues. It is also called intraparenchymal hematoma and may occur due to different reasons. For example:
- Hypertension
- Tumors
- Certain health conditions that lead to sudden leakage of the blood in the brain
- Poorly connected arteries or veins that usually are present at birth
- Aneurysm
Risk Factors
Head injuries usually cause intracranial hematomas. The activities that usually cause head injuries include riding a motorcycle or bicycle without head protection. However, the risk of this condition increases with aging, especially if you administer Aspirin or another anticoagulant daily or have an alcohol use disorder.
How to Prevent Intracranial Hematoma?
The following tips may help you prevent or avoid head injuries. For example:
- You should wear protective equipment (such as a helmet) during the following activities. These include contact sports, bicycling and motorcycling, skiing, horseback riding, skating, skateboarding, and snowboarding.
- It is advised to buckle your children’s and your seat belt as well each time you drive or ride in a motor vehicle.
- Always protect young children by using fitted car seats that prevent the children.
Diagnosis
In some cases, diagnosing this condition may be difficult because people with a head injury feel fine at first. In other words, they do not have any symptoms and do not go to the doctor. Check below some tests used to diagnose an intracranial hematoma:
- CT scan – This test uses X-rays to make pictures of the head, which help determine the location and size of the hematoma.
- MRI scan – It uses a magnetic field and radio waves to produce images of the brain. However, CT scans are more frequently used to diagnose an intracranial hematoma.
- Angiogram – This test is usually performed by doctors when there is a potential aneurysm in the brain or other blood vessel problems.
Treatment
Treatment to remove the hematoma usually is not needed if it is small and does not cause symptoms. In any case, the symptoms may happen or worsen several days or weeks after injury. In such cases, it is advised to monitor intracranial pressure repeatedly.
People who use blood thinners (anticoagulants) such as Warfarin, usually need therapies to reverse the effects of the medication. The most effective options to reverse anticoagulants include fresh frozen plasma and vitamin K.
Surgery
There are some types of surgery used to remove hematoma. Check below some of them:
- Surgical drainage – It involves a small hole in the skull to remove the liquid that collects inside the head.
- Craniotomy – This is a procedure in which a part of the skull is removed. It is usually recommended by doctors for people with large hematomas.
Unfortunately, recovery from intracranial hematomas often lasts a long period and anyway may not recover completely. If you recover within 6 months after injury it is considered the greatest recovery. However, if you continue to experience neurological symptoms, you may need physical and occupational therapy additionally.
Frequently Asked Questions
Is intracranial hematoma a serious health condition?
Yes, approximately 50% of people who experience it die. The survival chances of young people are significantly higher than older people. Consult your doctor for more details.
What are the most common symptoms of intracranial bleeding?
- Nausea
- Vomiting
- Weakness
- Numbness
- Paralysis
- Seizures
- Swallowing problems
- Vision problems
- Dizziness
- Confusion
- Persistent headaches
If you experience any of the previous symptoms, especially after a head injury, you may have an intracranial hematoma and you should immediately contact your healthcare professional.
What are the possible complications of an intracranial hematoma?
People with this condition may experience some complications, especially if they do not get treatment. Examples include:
- Hyperglycemia
- Infections
- Fever
- Seizures
- Neurological deficits
- Brain herniation
- Death
If you have additional questions, ask your healthcare professional.
