Intracranial hematoma is a pathological condition characterized by the accumulation of blood in the cranial cavity. Its danger lies in the fact that it can put pressure on, displace and damage nearby brain structures, causing them serious harm. The reasons for its appearance are traumatic injuries to the blood vessels of the brain or hemorrhages.
The Neurology Department of CELT invites you to undergo diagnostics and treatment of intracranial hematomas in Moscow. We employ leading domestic specialists who will accurately diagnose and select adequate treatment, which will certainly give the desired results. If you want to restore your health and get rid of severe symptoms, contact us and undergo treatment in accordance with international standards.
Etiology of intracranial hematomas
Intracranial hematomas are formed as a result of traumatic injuries or can be non-traumatic. Experts identify the following factors that can initiate their appearance:
- Ruptures of blood vessels due to traumatic brain injury;
- Bleeding that occurs after injury;
- Abnormal changes in blood characteristics during blood diseases;
- Diseases of the blood vessels of the brain;
- Destruction of the walls of blood vessels with a decrease in their plasticity, brain tumors, increased intravascular and blood pressure.
The hematoma itself can be formed by liquid or coagulated blood in a volume of one to one hundred milliliters. It puts pressure on the structures located around it, damages them and can cause them to die, and can also lead to swelling of the brain.
Clinic of subdural hematomas
Clinical manifestations of subdural hematomas are presented in two large groups, which can be found in our table below:
| Group of symptoms | Clinical manifestations |
| General cerebral symptoms of hematomas |
|
| Focal symptoms of hematomas |
|
Clinical manifestations of intracerebral hematoma
The severity of the symptoms of intracerebral hematomas depends on their location. Based on it, intracerebral, subdural and epidural hematomas are distinguished. The last two types always provoke compression of the brain, which determines their clinical manifestations. As for intracerebral hematomas, they tend to saturate the tissues with blood, which is why the affected areas cannot perform their functions, which also manifests itself in a certain way.
| Type of hematoma | Clinical manifestations |
| Intracerebral hematomas are located in the tissues of the brain. | Symptoms appear almost immediately after their formation and are most strongly felt by the patient in the second or third weeks. He suffers from:
|
| Subdural hematomas are localized between the arachnoid and dura mater. | During the light period, the patient notes:
After it is completed, consciousness becomes clouded, pain symptoms increase, and psychomotor agitation occurs. Signs of brain compression appear. |
| Epidural hematomas are located between the dura mater and the cranial bone. | Hematoma manifests itself as follows:
The condition worsens as tissue compression increases, blood pressure increases and then sharply decreases, the pulse quickens, the patient can fall into a coma and even die in severe cases. |
WHEN YOU SHOULD SOUND THE ALARM, THE FIRST SYMPTOMS OF HEMATOMA
A hematoma gives its symptoms and signs almost immediately after injury.
- Firstly, the skin at the site of the hematoma is sharply painful.
- After a short period of time, the site of injury begins to swell, the tumor can spread significantly and interfere with movement (for example, with a hematoma on the ankle, the swelling may be such that it is impossible to move independently or step on the affected leg).
- After swelling, the site of hemorrhage quickly turns red. Patients feel internal tension in the area of the hematoma; it is hard to the touch.
The color of the hematoma can be different - from bright red to purple, most often it is heterogeneous - its edges are darker, bluish in color, and the inside of the hematoma is red.
Treatment of intracerebral hematoma in CELT
Treatment of hematomas is carried out using conservative and neurosurgical techniques. Their choice depends on the diagnostic results and individual patient indications.
| Hematoma treatment methods | What is? |
| Conservative | Indicated for patients who have maintained clarity of consciousness with hematomas up to 30 mm and no signs of compression of the medulla oblongata. Treatment involves the administration of drugs that reduce the permeability of vascular walls. The procedure is carried out under the control of computed tomography. |
| Neurosurgical | Suitable for large hematomas with pronounced focal symptoms. Depending on the situation, the following removal methods are used:
If there are multiple hematomas, as a rule, only the largest ones are removed. |
The Department of Neurology at CELT sees neurologists and neurosurgeons with many years of experience in scientific and practical work. You can make an appointment with them online on our website or by contacting our operators: +7 (495) 788 33 88.
Make an appointment through the application or by calling +7 +7 We work every day:
- Monday—Friday: 8.00—20.00
- Saturday: 8.00–18.00
- Sunday is a day off
The nearest metro and MCC stations to the clinic:
- Highway of Enthusiasts or Perovo
- Partisan
- Enthusiast Highway
Driving directions
Diagnosis of subdural hematomas
Recognition of a subdural hematoma can be seriously complicated by the variety of its clinical manifestations. In order to correctly make a diagnosis, the neurologist takes into account the following factors:
- Nature and characteristics of traumatic injury;
- Development of disturbances of consciousness;
- Presence/absence of a light gap;
- Neurological status of the patient.
Instrumental diagnostic studies that are prescribed to the patient are presented as follows:
- X-ray of the skull;
- Detailed examination of the fundus (ophthalmoscopy);
- Cerebral angiography (study of cerebral vessels);
- Computer and magnetic resonance imaging, incl. and with contrast.
Hematoma on the head: prevention
If you have a head injury, you should follow some recommendations to speed up your recovery.
Recommendations:
- Adequate rest and sleep,
- Getting rid of bad habits
- Avoid hazardous activities
- You must take all prescribed medications
- You should gradually return to a normal lifestyle.
A hematoma on the head is an unpleasant occurrence. A small bruise can be treated with medication. A bruise of impressive size can cause quite unpleasant consequences, even death.
Treatment
The goal of treatment is to reduce systemic manifestations of the inflammatory response.
If necessary, apply a bandage to the site of impact
In mild cases, with subcutaneous bruises, a tight bandage is applied. In the presence of intense subcutaneous hemorrhage, it is necessary to open it, which is performed under local anesthesia.
Typically, the hematoma is semi-liquid and can be removed through a small hole using a flexible endoscope. The endoscope is equipped with a video camera, which allows you to take photos if necessary.
Treatment of chronic subdural hematomas
With this type of pathology, spontaneous resorption is often observed, which allows for conservative therapy. This is only possible in the absence of neurological deficit and with periodic monitoring using computed tomography.
Main indications for conservative treatment:
- small amount of damage with the patient remaining in the clinical phases of subcompensation and compensation;
- spontaneous reduction in the volume of damage during repeated studies, if there is a positive trend in neurological symptoms;
- patient's refusal to undergo surgery.
Treatment at home
At home, treatment of a hematoma on the head after a bruise can be carried out only in mild cases. Therapy consists of applying cold to the injury site in the first hours after the injury. In the future, it is necessary to apply external agents to the area of impact to promote the resorption of the resulting bruise.
It must be remembered that the symptoms of the pathology may not appear immediately, so you should carefully monitor changes in your physical, emotional and mental state.
It is also important to tell family members about the injury, as hemorrhage may be accompanied by further memory loss.
The adequacy of the therapy is assessed by stabilization of the general condition and regression of external manifestations of the injury.
Traditional methods
To resolve the hematoma, unconventional methods of treatment are suitable:
- In order to apply a compress, brew black tea (take a couple of teaspoons per ½ cup of boiling water) and let it steep for half an hour. Moisten a cotton swab and apply to the damaged area for 18-20 minutes. The manipulation is repeated 3 times a day. Bagged tea will also work.
- With the help of an aloe leaf, the inflammatory process is relieved. Cut lengthwise and apply half to the damaged area for 30 minutes.
- A cabbage leaf will do. Apply it to the bruised area, but before using it, it must be mashed to release the juice.
- Mix chili pepper and 5 tablespoons of Vaseline. This ointment is applied to the hematoma and kept for 9-10 minutes.
What medications will help?
Medical advice is required before using any medicine. As a rule, subcutaneous hemorrhages are treated with:
- Troxevasin ointment. Thanks to her, the bruise will quickly resolve. When applied to the bruised area, the increase in subcutaneous hemorrhage will immediately stop. It is recommended to use 2 times a day.
- Lyoton gel. It restores tissue, resolves hematoma well, and improves blood flow. Apply it for 7 days two to three times a day.
- Badyagi (lat. Spongilla). This product has an irritating effect, as a result of which local microcirculatory processes improve. The product acts as an antiseptic and also has a regenerative effect. Apply 4-5 times per day for no more than 20 minutes.
Forecast
With the epidural form of the pathology, in case of timely treatment, the prognosis is good. The prognosis of subdural hemorrhage varies widely and depends on the size of the affected area and the duration of the injury.
It is also important to consider that intracranial hematomas in most cases are accompanied by other serious injuries: subarachnoid hemorrhage, diffuse axonal damage to the brain, contralateral contusions, etc.
After any significant impact to the head resulting in loss of consciousness, or in the event of any signs that may indicate the presence of a hematoma, you should consult a doctor.
Symptoms
Symptoms of hemorrhages on the head may not be expressed, most often it manifests itself in the form of a headache. You may also experience an unpleasant sensation such as slight dizziness when changing your body position or moving vehicles in front of your eyes.
One of the main symptoms of the pathology is headache
Other possible signs of pathology:
- vomiting, nausea;
- drowsiness;
- confusion;
- loss of speech or slow speech;
- weakness in the limbs on one side of the body;
- difference in pupil size.
In the early stages of injury, an accurate diagnosis can often only be made through special studies. Therefore, in case of any head injury, it is recommended to immediately contact a neurologist or neurosurgeon.
Hematomas in a newborn
A hematoma on a child’s head often occurs during childbirth. There are two main causes of bruising in a newborn.
Causes:
- Compression of the baby's head when passing through the birth canal.
- Sudden change in blood pressure at birth.
There are factors that increase the risk of such a pathology.
Factors:
- Prematurity,
- Discrepancy between the size of the child’s head and the lumen of the mother’s birth canal,
- Using forceps or a vacuum during childbirth
- The newborn is quite large,
- Use of caesarean section.
A hematoma on the head of a newborn after birth should go away on its own in about two weeks. The larger the damage, the longer it will take to heal.
The gradual disappearance of the bruise and good health indicate a normal healing process.
In certain cases, aspiration may be used. It is carried out in cases of no improvement. To remove a hematoma, two needles are used - one is used to pump out the blood, the other is used to normalize the pressure. The operation is carried out quickly, and relief in children occurs after a short period of time.
A bruise on a baby’s head is not considered dangerous, but requires observation and care. If parents notice that the child is nervous, capricious, eats and sleeps poorly, then they should contact a pediatrician.
Causes of pathology
The brain is located inside the skull, it is enclosed in soft membranes and washed with blood and brain fluid. They occupy a volume of 1.5–2 liters. These fluids are incompressible, so if blood begins to pour into the cranial cavity during a rupture of a vessel or an impact, a displacement of the brain occurs - dislocation.
Of the total number of head injuries, hematomas make up no more than 10%. However, they are the ones that account for the highest mortality rate. The most serious cases during hospitalization occur in unconscious victims.
In addition to traumatic etiology, hemorrhage can be vascular or iatrogenic in nature, occurring due to hemophilia, craniocerebral disproportions, sepsis, brain tumors, intoxication, etc.
Complications may be
For small hematomas, the prognosis is favorable. They are treated conservatively and go away quite quickly. Lack of therapy can cause adverse effects and complications.
What could be:
- A hematoma can compress brain tissue. A person’s consciousness is gradually impaired, the sensitivity of the limbs is lost, and vision problems arise.
- An internal hematoma on the head can cause bleeding in the brain, resulting in death.
- The development of inflammatory processes and the formation of an abscess are possible.
Any damage to the head can lead to disruption of the entire body. Therefore, going to a medical institution is mandatory.
Minimally invasive method for removing subcutaneous hematomas
Subcutaneous hematomas are one of the most common types of injuries resulting from trauma. Most often they turn out to be harmless bruises, but in some cases hematomas can be dangerous. Thus, with the formation of large-volume hematomas, the risks of developing infectious complications sharply increase and, what is especially important, the pressure exerted by the bleeding leads to disruption of the blood supply to the overlying layers of tissue, and this, in turn, is fraught with the development of necrosis.
In this case, it becomes necessary to empty the hematoma cavity. Solving this problem may not be as easy as it seems at first glance. Conventional aspiration is often ineffective due to the formation of a large number of clots that clog the needle channel, and surgery is not only associated with risk, but is sometimes impossible due to the need for lengthy preoperative preparation.
The solution, according to the authors of this old, but still relevant article, lies in the following. You need to take two syringes with a volume of 50 and 10 ml and 1 needle of size 16 on the Gage scale (photo 1). The needle should be attached to a 50 ml syringe. With a sharp end at an angle to the skin, the needle is inserted into the hematoma cavity. Due to impaired sensitivity in the area of skin compressed by the hematoma, local anesthesia is not required. The plunger of the 50 ml syringe is then pulled up so that the 10 ml syringe can be placed between the plunger and the base of the 50 ml syringe, as shown in Photo 2. In this way, continuous aspiration is achieved without much effort by the clinician. Meanwhile, the doctor moves the needle into the hematoma cavity in different directions, destroying the clots. When the syringe is filled with 50 ml, the syringe itself is disconnected from the needle, emptied of its contents and reattached, repeating all the steps described above. Upon completion of the procedure, a pressure bandage is applied.
Photo 1 | Tools required for the procedure
Photo 2 | Assembly. The plunger of the 50 ml syringe is pulled back so that a small syringe can be placed. This will allow you to suction without straining.
It is important to note that this technique is used primarily to reduce the pressure exerted by the hematoma, and not to remove all the spilled blood. Complete removal is very problematic, carries unjustified risks, and in addition, the remaining clots contain clotting factors, which, together with a pressure bandage, prevent re-hemorrhage.
The method described is simple and quick, making it very useful in various accidents.
