Intracranial Hematoma

Overview

An intracranial hematoma is a collection of blood within the skull, usually caused by a blood vessel that bursts in the brain or trauma such as a car accident or fall. It may press on the brain, leading to potentially life-threatening consequences. Symptoms can appear right after a head injury or may take weeks or longer to appear. They include a worsening headache, vomiting, and increased pressure on the brain.

Understanding the disease

Symptoms

The symptoms of an intracranial hematoma may include a headache that gets worse, vomiting, drowsiness and progressive loss of consciousness, dizziness, confusion, unequal pupil size, slurred speech, loss of movement (paralysis) on the opposite side of the body from the head injury, lethargy, seizures, and unconsciousness. If you experience any of these symptoms after a blow to the head or head injury, seek immediate medical attention as it can be life-threatening.

Risk Factors

The risk factors for developing intracranial hematoma include:

1. Head injury: The most common cause of intracranial hematoma is head injury due to trauma from accidents, falls, or sports injuries.
2. Age: Older adults are more susceptible to intracranial hematoma, especially if they are taking blood-thinning medications or anti-platelet drugs like aspirin.
3. Previous head injury: Having a history of head injury increases the risk of developing intracranial hematoma, especially if the previous injury was severe or occurred repeatedly.
4. Use of blood-thinning medications or anti-platelet drugs: Taking blood-thinning medications or anti-platelet drugs like aspirin can increase the risk of intracranial hematoma, especially in older adults.
5. Certain medical conditions: Certain medical conditions like high blood pressure, aneurysms, arteriovenous malformations, or weakened blood vessels can increase the risk of intracranial hematoma.
6. Genetics: Some inherited genetic conditions, such as von Willebrand disease or hemophilia, can increase the risk of intracranial hematoma. It's important to note that the risk factors listed above may also apply to other types of intracranial hematomas, such as subdural hematoma or epidural hematoma.

Development

Intracranial hematomas develop when blood vessels within the skull rupture or leak blood, causing a collection of blood within the skull. There are three main types of intracranial hematomas: subdural, epidural, and intracerebral (intraparenchymal). Subdural hematomas occur when blood vessels burst between the brain and the outermost protective layer (dura mater). The leaking blood forms a hematoma that presses on the brain tissue. There are three types of subdural hematomas: acute, subacute, and chronic. Epidural hematomas occur when blood collects between the dura mater and the skull's outermost layer. This type of hematoma is less common than subdural hematomas. Intracerebral (intraparenchymal) hematomas occur when blood pools in the tissues of the brain. They can result from various causes such as trauma, rupture of a bulging blood vessel (aneurysm), poorly connected arteries and veins from birth, high blood pressure, and tumors. All types of intracranial hematomas are potentially life-threatening and require immediate medical attention upon the appearance of symptoms.

Assessment and Diagnosis

Triage

If you suspect an intracranial hematoma, it is important to seek emergency care immediately. Signs and symptoms that require immediate medical attention include:

• Abrupt, severe headache
• Headache with a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties
• Headache after a head injury, especially if the headache gets worse These symptoms could indicate a serious medical condition that requires immediate treatment to prevent permanent brain damage. Remember, if you experience any head injury, it is crucial to seek medical attention and consult with a doctor even if the symptoms seem minor. Head injuries can have delayed onset or may not appear severe initially but can still necessitate medical intervention.

Diagnosis

To diagnose an intracranial hematoma, doctors typically assume that bleeding inside the skull is the cause of progressive loss of consciousness after a head injury until proved otherwise. Imaging techniques such as CT scans and MRI scans are the best ways to determine the position and size of a hematoma. Blood tests, including tests to check how fast the blood clots, whether the blood sugar is too high or low, and whether there is an infection, may also be performed. In some cases, an angiogram may be necessary to provide more information about possible blood vessel problems.

Management and Treatment

Complications

Potential complications of an intracranial hematoma include:

1. Increased intracranial pressure: As the hematoma accumulates more blood and presses on the brain, it can cause increased intracranial pressure, leading to brain damage or even death.
2. Hydrocephalus: The accumulation of blood can cause a blockage of the normal flow of cerebrospinal fluid, leading to the formation of fluid-filled cavities in the brain (hydrocephalus).
3. Brain herniation: The swelling from the hematoma can cause the brain to shift and press against the skull, potentially causing brain herniation, which is a life-threatening condition.
4. Seizures: The pooling of blood in the brain can cause irritation and disrupt the normal functioning of brain cells, leading to seizures or convulsions.
5. Stroke: The bleeding may cause a stroke by blocking or disrupting blood flow to the brain.
6. Long-term neurological complications: Even if the individual survives the initial injury, they may experience long-term neurological complications, such as cognitive impairment, memory loss, or difficulty with physical functions. It is crucial to seek immediate medical attention if you or someone you know experiences any symptoms related to an intracranial hematoma, as prompt treatment can help minimize potential complications and improve the chances of recovery.

Home Remedies

It is important to consult a medical professional for proper diagnosis and treatment of intracranial hematoma.

Treatment

Immediate treatment for an intracranial hematoma is usually necessary due to its potential life-threatening nature. Treatment options may include:

1. Surgery: In many cases, surgery is required to remove the accumulated blood and relieve pressure on the brain. This may involve a craniotomy, where a portion of the skull is temporarily removed to access the brain.
2. Blood transfusion: In some cases, a blood transfusion might be necessary to replace lost blood and restore blood pressure, especially if the hematoma is caused by trauma or bleeding disorders.
3. Medications: Depending on the underlying cause and severity of the hematoma, medications may be prescribed to manage symptoms, prevent seizures, or control blood pressure. It is important to note that the specific treatment approach for an intracranial hematoma will depend on the individual case, the severity of symptoms, and the underlying cause. Prompt medical attention and consultation with a healthcare professional are crucial in determining the appropriate course of treatment.

Preparing for medical consultation

To prepare for an appointment for an intracranial hematoma, you should:

1. Be aware of any pre-appointment restrictions: At the time you make the appointment, inquire if there are any specific instructions or preparations needed, such as fasting for a specific period before the appointment.
2. Write down any symptoms you're experiencing: Include any symptoms related to the intracranial hematoma, as well as any other symptoms that may seem unrelated.
3. Make a list of all medications, vitamins, and supplements you're taking: This will help your healthcare provider understand your overall medical history and current health status.
4. Consider taking a family member or friend along: Having someone accompany you can help you remember important details and provide emotional support.
5. Bring previous scans or X-rays and any other relevant medical records: This will help the healthcare provider review your medical history and make an informed diagnosis and treatment plan.
6. Prepare a list of questions to ask your doctor: Identify the most important questions you have and prioritize them in case time runs out during the appointment. Remember to arrive on time and communicate openly with your healthcare provider about your symptoms, concerns, and medical history.