Intracranial hematoma

Intracranial hematoma is an accumulation of blood within the brain or between the brain and the skull due to rupture of the blood vessel. This compresses your brain tissue and hence it is considered as a life-threatening emergency. Surgery is often required to manage this condition. Intracranial hematoma is of various types:

  • Epidural hematomas - forms between the skull and outer layer of tissues covering the brain

  • Subdural hematomas - forms between the outer and middle layers of the brain

  • Subarachnoid hemorrhage - forms between the brain and thin tissues covering the brain

  • Intracerebral hematomas - forms within the brain

Causes

Motorcycle accidents, falls, and sports injury are the common causes of intracranial hematomas. If you are old and are taking an anticoagulant or antiplatelet drug such as aspirin, then even a mild head injury can result in a hematoma.

Signs and symptoms

The signs and symptoms vary depending on the type of hematoma. However, there are few common symptoms of brain hemorrhage:

  • Sudden and severe headache
  • Mild and long-lasting headache
  • Confusion and slurred speech
  • Drowsiness
  • Severe vomiting within 24 hours
  • Seizure
  • Increased blood pressure
  • Progressive loss of consciousness

Call the doctor immediately when someone experiences any of these symptoms and loses consciousness suddenly.

Diagnosis

Intracranial hemorrhage is hard to diagnose as most of the patients do not show signs and symptoms after the injury. However, doctors suspect hematoma in the brain if there is a loss of consciousness.

Brain computed tomography (CT scan) is the first step to diagnose intracranial hematoma. This test helps the doctor to see abnormalities like swelling and clot in the brain.

Magnetic resonance imaging (MRI) scan is also done to take computerized images of the complete brain.

If the doctor observes that there is no hemorrhage, and still the symptoms persist, then a lumbar puncture, also called spinal tap test is suggested to test the fluid that cushions the spine and the brain.

Treatment

Treatment is not required for small hematomas as the patients do not show any signs and symptoms. But you need to check your symptoms and go for repeated tests if you suspect brain injury. The different treatment options include:

  • Surgery is usually performed to relieve pressure on the skull. The doctors may drill a small hole in the skull to release blood or to remove a blood clot from the damaged area. For larger hematomas, a section of your skull is opened to remove the blood.

  • Medications such as steroids (to reduce swelling), anticoagulants (to reduce clotting), and anti-epileptics (to reduce seizures) are also prescribed.

  • You doctor may suggest you to stop taking warfarin (if you are taking) to reduce the risk of excess bleeding.

  • In some cases, physical or occupational therapy is recommended.

Self-management

Follow these tips for fast recovery:

  • Get enough rest when you feel tired and sleep well at night.
  • Avoid playing outdoor games to prevent further injury.
  • Avoid alcohol as it increases the risk of the second injury.
  • Talk to your friends and family to stay mentally strong.