Intracranial hematoma

Overview

An intracranial hematoma is a condition where blood accumulates in the skull, usually due to a ruptured blood vessel in the brain or head trauma. The blood may collect in the brain tissue or beneath the skull, putting pressure on the brain and preventing oxygen from reaching it. Oxygen is crucial for the brain to function properly, as it relies on a network of blood vessels to supply it with oxygen and nutrients. If the brain is deprived of oxygen for more than three to four minutes, the nerve cells can die and the related functions they control may be impaired.

The severity and consequences of a brain hemorrhage are determined by various factors, including the underlying cause, the site of bleeding within the skull, the size of the hemorrhage, the duration between the onset of bleeding and medical intervention, as well as the individual’s age and overall health. It’s important to note that brain cells cannot regenerate once they are damaged or destroyed. Consequently, the damage from a brain bleed can be significant and lead to impairment in physical, cognitive, and functional abilities. Intracerebral hematoma should be treated as a medical emergency.

Symptoms

The symptoms of an intracranial hematoma vary depending on the location of the brain affected. In most cases, the signs and symptoms may arise immediately after a head injury, or they may appear weeks or months later. A lucid interval may also occur following a head injury.

When pressure on the brain builds up over time, initial signs and symptoms may occur. However, other signs and symptoms may arise as more blood fills the brain or the narrow gap between the brain and skull.

An intracranial hematoma may generally have the following signs and symptoms:

• Intense “thunderclap” headache, or headache that worsens overtime
• Vomiting and nausea
• Tingling, numbness, or paralysis of the face, arm, or leg, often on one side of the body
• Drowsiness and increased loss of consciousness
• Dizziness or confusion
• Unequal pupil size
• Abnormal or slurred speech
• Lethargy
• Seizures
• Unconsciousness
• Breathing difficulties and an irregular heart rate
• Vision loss or difficulties seeing
• Balance or coordination problems

An intracranial hematoma can be a serious medical condition that requires immediate attention. If you experience any of the following symptoms after a blow to the head, seek medical help right away: losing consciousness, having a persistent headache, feeling nauseous or vomiting, experiencing weakness, blurred vision, or unsteadiness.

If there are no noticeable symptoms, it is advisable to have someone monitor the person for any physical, mental, or emotional changes. Sometimes, memory loss resulting from a head injury may cause individuals to forget about the blow. If someone appears to be fine initially but then suddenly loses consciousness, they need urgent medical attention. The sooner the condition is treated, the better the chances of survival.

Causes

Intracranial hemorrhage has several causes which usually involves a fall, automobile accident, sports injury, or other form of impact to the head that can result in head trauma. High blood pressure (hypertension), which can cause blood vessel walls to deteriorate and leak or burst can also cause intracranial hemorrhage.

Even if there is no open cut, bruise, or other visible damage, one can sustain a serious injury. Even minor head trauma can result in a hematoma in an elderly person. This is especially true for people who are on a blood thinner or an anti-platelet medicine, such as aspirin.

To better comprehend intracranial hematoma, it is necessary to first understand the various forms. Hematomas are classified into three types: subdural hematomas, epidural hematomas, and intracerebral (intraparenchymal) hematomas.

• Subdural hematoma: Subdural hematoma is a condition in which blood vessels burst between the brain and the outermost protective layer called the dura mater. The leaked blood forms a hematoma that can cause pressure on the brain tissue, leading to breathing difficulties, paralysis, and even death if left untreated. Medical attention should be sought as soon as symptoms appear to avoid permanent brain damage. The risk of subdural hematoma is higher in older people, especially those who take blood-thinning medication regularly or misuse alcohol.

Subdural hematomas are classified into three type:

• • Acute: Acute subdural hematoma is the most dangerous type, as symptoms are severe and appear immediately after a head injury. If not diagnosed and treated quickly, it can lead to unconsciousness, paralysis, or even death.
  • Subacute: Subacute subdural hematoma symptoms usually appear hours to days after the injury and can occur with a concussion.
  • Chronic: Chronic subdural hematoma is more common in older people and bleeding occurs slowly, so symptoms may not appear for weeks or months. This type of hematoma can result from even minor head injuries and changes can be so subtle and occur so slowly that symptoms may not be noticed by the older person or their friends or family.
• Epidural hematoma: This type of hematoma is known as an epidural hematoma and can occur when a blood vessel ruptures between the outer surface of the protective layer covering the brain and the skull. When this happens, blood escapes from the ruptured vessel and accumulates between the protective layer and the skull, forming a mass that exerts pressure on the brain tissue. Trauma is the most common cause of epidural hematoma. While some individuals may remain awake after experiencing this type of injury, most typically become drowsy or unconscious immediately following the trauma. If an artery in the brain is affected by the epidural hematoma, urgent medical attention is required as the condition can be life-threatening.
• Intracerebral (intraparenchymal) hematoma: This kind of hematoma happens when blood accumulates in the brain’s tissues. It can be caused by various factors, such as head injuries, high blood pressure, aneurysms, birth defects in the connections between arteries and veins, or tumors. Certain diseases can also lead to spontaneous bleeding in the brain. In cases of head injuries, multiple intracerebral hematomas can occur.