Intracranial hematoma : Causes-Symptoms-Diagnosis-Treatment


 What Is Intracranial Hematoma?

An intracranial hematoma is a set of clotted blood that forms within the skull after an injury. At Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, our neurosurgeons specialize in treating intracranial hematoma. Standard treatment might also include expert monitoring and/or surgery for drainage.

A hematoma may also position stress on tissue of the brain, causing harm. Physicians categorize hematomas consistent with the onset and quantity of intracranial bleeding. An acute hematoma may be life-threatening and therefore require emergency treatment. A persistent hematoma, even though much less dangerous right now, can also necessitate treatment to limit effect on cognition or mobility. Treating a persistent hematoma can also in part repair characteristics or save you in addition to deterioration.

What Is Intracranial Hematoma?
Intracranial Hematoma

A subdural hematoma is a form of bleeding internal to your head. It's a sort of bleed that occurs inside your cranium however outside the actual mind tissue. The mind has three membrane layers or coverings (referred to as meninges) that lie between the bony skull and your mind tissue. The reason for the meninges is to cover and shield the brain.

If you have got a subdural hematoma, you have experienced a tear in a blood vessel, usually a vein, and blood is leaking out of the torn vessel into the space underneath the dura mater membrane layer. This space is referred to as the subdural space due to the fact it is below the dura. Bleeding into this area is called a subdural hemorrhage.

Other names for subdural hematoma are subdural hemorrhage or intracranial hematoma. More widely, it's also a kind of stressful brain injury (TBI).

  1. Nervous system
  1. Brain

  2. Cerebral hemispheres

  3. Diencephalon or interbrain

  4. Thalamus

  5. Hypothalamus

  6. Midbrain

  7. Cerebellum

Medical terms

  • An intracranial hematoma is a collection of blood in the skull. It's most commonly caused by the rupture of a blood vessel within the brain or from trauma, such as a car accident or fall. The blood can collect within brain tissue or underneath the skull, pressing on the brain.
  • A head injury that causes only a brief lapse in consciousness is usually not very serious. However, an intracranial hematoma - which is potentially life-threatening - requires immediate treatment which might include surgery to remove the blood.
  • Intracranial hemorrhage encompasses 4 large kinds of hemorrhage: epidural hemorrhage, subdural hemorrhage, subarachnoid hemorrhage, and intraparenchymal hemorrhage. Each sort of hemorrhage outcomes from exceptional etiologies and the clinical findings, prognosis, and consequences are variable. This activity offers a vast evaluation of the sorts of intracranial hemorrhage and the role of the interprofessional team in handling affected patients.
  • is a type of stroke Intracranial hematomas are a major cause of death in patients who have been treated for acute head trauma including those with intracranial hemorrhage Risk factors include age greater than 60 years history of falls and alcohol abuse The incidence of intracranial hematoma after head trauma ranges from 3% to 20%.

An intracranial hematoma is a collection of blood outside the brain It can form when blood leaks through a hole in a weakened area of the skull called a cranial vault fracture Bleeding occurs as a result of trauma to the head or skull such as the type you’d experience in a car accident.

Types of subdural hematomas

Yes. Doctors type subdural hematomas with the aid of how rapidly they increase, how a whole lot of bleeding happens, and what kind of harm the bleeding causes. The kinds of subdural hematoma are:

  • Acute: This is the maximum dangerous form of subdural hematoma. Symptoms are severe and seem proper after a head damage, regularly inside mins to hours. Pressure at the mind increases fast as the blood pools. If not diagnosed and treated quickly, you could lose awareness, grow to be paralyzed or maybe die.

  • Subacute: Symptoms typically appear hours to days or even weeks after the top damage. A subacute subdural hematoma can arise with a concussion.

  • Chronic: This form of hematoma is greater common in older humans. Bleeding happens slowly and symptoms may not appear for weeks or months. Even minor head accidents can cause continual subdural hematomas. Due to the delay in growing signs and symptoms, an older individual won't even bear in mind how their head damage occurred. Also, the changes may be so subtle and arise so slowly that signs and symptoms won't be noticed by the older character or their buddies or family.

Symptoms Intracranial hematoma

In some cases, signs of an intracranial hematoma seem right now after a head injury; in different instances, the onset of symptoms isn't always till hours, days or maybe weeks later. Delayed onset is fantastically commonplace for subdural hematomas in older people.

The following signs ought to imply bleeding within the mind and/or an intracranial hematoma. Anyone who exhibits one or extra of those signs and symptoms after a head injury needs to receive instant medical attention.

After a head injury, you may develop signs and symptoms of an intracranial hematoma (a type of brain injury) right away, or it may take weeks or longer for them to appear. During the "lucid interval" (a period following a head injury during which you appear to be fine), be aware of these signs: feeling confused or disoriented, seeing double, trouble with balance or coordination, or seizure.

When you have a lot of things to do, your brain can start to work faster than normal, which can lead to some or all of the following signs and symptoms: - feeling stressed - having trouble concentrating - being anxious

  • Increasing headache

  • Vomiting

  • If you drink too much alcohol, you may become drowsy and unable to stay conscious.

  • Dizziness

  • Confusion

  • Unequal pupil size

  • Slurred speech

  • If you have a head injury on one side of your body, but lose movement on the opposite side of your body, that means you have a brain injury.

As your brain fills with more blood, other signs and symptoms may become apparent, such as:

  • Lethargy

  • Seizures

  • Unconsciousness

When to see a doctor

A hematoma in the brain can be life-threatening and require emergency treatment.

Seek immediate medical attentionAfter a blow to the head, you should:

  • Lose consciousness

  • Have a persistent headache

  • Vomiting, dizziness, and weakness can occur after you have a stomach virus. Your vision may be blurry and unsteady.

If you see signs or symptoms after someone has been hit in the head, watch for changes in behavior or mood. For example, if someone seems fine after getting hit in the head, but later becomes unconscious, go to the hospital right away.

Even if you feel okay, it's always a good idea to ask someone to keep an eye on you. Memory loss after a head injury can make you forget about the injury. Someone you tell might be more likely to notice the warning signs and get you help.

Causes Intracranial hematoma

Head accidents motive most subdural hematomas. If you fall and hit your head or take a blow to the head in a car or motorbike twist of fate, a sporting interest or have some other type of head trauma, you're at danger for growing a subdural hematoma.

A head injury is the most common cause of bleeding inside the skull. Head injuries may occur from motor vehicle or bicycle accidents, falls from height, assaults, and sports injuries.

If you are an older adult, even a mild head trauma can cause a blood clot. This is especially true if you are taking a blood-thinning medication or an antiplatelet drug such as aspirin.

Even if there is no visible damage, you can still have a serious injury.

There are three types of hematomas - subdural, epidural, and intracerebral.

Subdural hematoma

This happens when blood vessels break between your brain and the outermost layer of skin that covers your brain (dura mater). This leaking blood forms a hematoma, which presses on the brain tissue. If this hematoma grows larger, it can slowly cause you to lose consciousness. Decoupage is risky because it might lead to death.

There are three types of subdural hematomas. They are:

  • Acute.This type of concussion is the most dangerous and generally results from a severe head injury. Signs and symptoms usually appear immediately.

  • Subacute.It can take some time for signs and symptoms to develop after an injury. Sometimes they can show up a few days or weeks later.

  • Chronic. If you suffer from a less severe head injury, this type of hematoma can occur and can take weeks or even months to show up. You might not remember injuring your head. For example, if you bump your head while getting into the car, it's possible that you could experience bleeding especially if you're on blood-thinning medication. Medicine is something that helps you feel better.

All three types of poisoning require medical attention as soon as signs and symptoms appear in order to prevent permanent brain damage.

The risk of subdural hematoma increases as you get older. It is also greater for people who:

  • Take medication to reduce the risk of blood clots every day.

  • Misuse alcohol

Epidural hematoma

This type of hematoma occurs when a blood vessel ruptures between the outer surface of the dura mater and the skull. Blood then leaks out and forms a mass that presses on brain tissue. The most common cause of an extradural hematoma is an artery rupture. Epidural hematoma is a type of trauma.

Most people who have this type of injury become drowsy or go into a coma right away. A hematoma that affects an artery in your brain can be deadly if it is not treated quickly.

A blood clot in the brain.

This type of hematoma is also known as an intracranial hematoma. It can occur as a result of trauma, when a bulging blood vessel ruptures, when poorly connected arteries and veins are due to birth or high blood pressure, or when diseases cause it. A head injury can cause blood to leak into the brain. This can lead to multiple severe intracerebral hematomas.

Risk factors Intracranial hematoma

Most ICHs are because of a head injury. Any activities or way of life picks that place you at risk for a head injury can lead to ICH.

Intracranial hematomas may also occur with moderate or severe accidents to the head, together with those sustained in the course of a motor automobile accident, a bicycle twist of fate, a fall, or an act of violence.

Some people are vulnerable to growing hematomas—specifically subdural hematomas—after seemingly minor head accidents. Groups at particular threat include those:

  • Over the age of 60

  • Who abuse alcohol

  • Who take blood-thinning medication like aspirin or Warfarin

  • Who experience repeated head trauma

Can an intracranial hematoma go away?

An intracranial hematoma is a type of brain bleed caused by a ruptured blood vessel or collection of blood outside the brain This can occur after head trauma such as a car accident or sports injury Can an intracranial hematoma go away? Yes in some cases the blood can be absorbed into the surrounding tissue In other cases surgery is needed to remove the clot If left untreated a large hematoma can cause permanent damage and even death.

Can a brain bleed heal itself?

A person who suffers a brain bleed may be able to heal by themselves The brain is a complex organ and complex organs can heal by themselves It depends on the severity of the bleed the patient's overall health and other factors If a person has had one bleed and then another it is more likely that this person will not heal by himself A doctor should still be consulted for guidance.

How long does it take a brain hematoma to heal?

A brain hematoma is a collection of blood on the surface of the brain The injury can occur when there is an external trauma such as a fall or car accident or it can be caused by an internal injury in which the skull is fractured and the hematoma forms between the dura and skull The symptoms of a hematoma include headache nausea vomiting changes in vision and trouble speaking If a person sustains enough damage from the hematoma they may experience coma or death.

What happens if a brain bleed goes untreated?

A hemorrhagic stroke occurs when a blood vessel in the brain ruptures resulting in bleeding into the surrounding tissue Hemorrhagic strokes account for 10 percent of all strokes but are more common as people age The loss of blood flow results in tissue death and cell damage which can lead to paralysis on one or both sides of the body speech problems and memory loss If left untreated a hemorrhagic stroke can result in death.

Prevention Intracranial hematoma

There are ways to prevent or minimize head injury:

  • Be sure to wear a helmet when you ride your bike. And make sure your kids do too!Be sure to wear an appropriate and properly fitted helmet when playing contact sports, such as bicycling, motorcycling, skiing, horseback riding, or skating.

  • Make sure your kids are strapped in and buckle your seat belt.When you're driving or riding in a motor vehicle, always wear your seat belt.

  • Protect young children.Make sure to use a car seat pad on the countertop and edges of tables, and to block stairways when tethering heavy furniture or appliances to the wall. Keep children from climbing on unsafe or unsteady objects by placing furniture or appliances on the floor instead.

Diagnosis Intracranial hematoma

The first step your health practitioner will take to diagnose ICH is a CT test of your head. A CT scan can display abnormalities to your mind like swelling or clots.

The CT test might not show any signal of ICH. If you’re nonetheless having symptoms, your health practitioner may pick to perform a lumbar puncture, or spinal faucet, to test the fluid that cushions your backbone and mind.

It can be difficult to diagnose an intracranial hematoma because people who have a head injury might look OK. However, doctors generally assume that if someone has been injured and is losing consciousness, the cause is likely a brain bleed until proven otherwise.

Imaging techniques can determine the position and size of a hematoma. These include:

  • CT scan.This uses a sophisticated X-ray machine that is linked to a computer to produce detailed images of your brain. You are placed still on a movable table, and the images are taken of your brain inside what looks like a large doughnut. CT is the most commonly used imaging scan to diagnose intracranial hematomas.

  • MRI scan.An MRI scan is done using a magnetic field and radio waves to create computerized images of your body. You are placed on a movable table that is guided into a tube, so you can see inside your body.

  • Angiogram.If there is a concern about a possible aneurysm in the brain or other blood vessel problem, an angiogram might be necessary to provide more information. This test uses X-rays and a special dye to produce pictures of the blood flow in the blood vessels in the brain.

Treatment Intracranial hematoma

Healthcare providers treat large hematomas with decompression surgical procedures. A medical professional drills one or more holes in the skull to empty the blood. Draining the blood relieves the stress the blood buildup causes on the brain. Additional surgical operation can be needed to do away with huge or thick blood clots if present. Usually, healthcare companies go away from a drain in the region for several days following surgical treatment to allow the blood to maintain draining.

Sometimes hematomas motivate few or no symptoms and are small enough that they don’t require surgical treatment. Bed relaxation, medicines and remarks may be all that is needed. The frame can take in a small quantity of blood over the years, typically some months. Your healthcare companies may also order ordinary imaging exams (which include an MRI) to display the hematoma and ensure its far recovery.

If you don't experience any signs or symptoms, your hematoma won't need to be removed. However, if you do experience signs or symptoms later on, you might have to be monitored for neurological changes and have your intracranial pressure monitored. A head CT scan is a type of medical imaging that uses X-rays to view the inside of your head.

If you are taking blood thinners such as warfarin (Coumadin Jantoven), you may need therapy to reverse the effects of the medication. This will reduce the risk of further bleeding. Options for reversing blood thinners include receiving vitamin K and fresh frozen plasma.


If you have a hematoma, it may be treated with surgery. The type of surgery depends on the type of hematoma you have.Some possible treatments are:

  • Surgical drainage.If the blood is located in a specific area and has transitioned from a solid to liquid state, your doctor might create a small hole in your skull and use suction to remove the liquid.

  • Craniotomy.If a large hematoma accumulates in your head, doctors might have to open up your skull (a craniotomy) to remove the blood.


Recovery after an intracranial hematoma can take a long time, and you might not fully recover. The greatest period of improvement is usually up to three months after the injury, but there may be some improvement after that. If you continue to have neurological problems, you might need additional treatment. Physical and occupational therapy can help you recover from your injuries.

  1. Rehabilitation of The Brain and Nerves

Coping and support

It is important to have patience while coping with a brain injury. Adults will have the majority of their recovery in the first six months. After that, there might be smaller, more gradual improvements for up to two years after the hematoma occurs.

To aid your recovery:

  • Get enough sleep at night,Take a break in the daytime when you feel tired.

  • Ease back into your normal activities when you feel stronger.

  • Do not participate in contact sports or recreational sports. until you get your doctor's OK.

  • Talk to your doctor.Before you engage in any physical activity, like playing sports, driving a car, or riding a bike, be sure to take precautions to ensure your reaction time remains normal. Your brain injury may have slowed your movements down.

  • Check with your doctor before taking medication.

  • Do not drink alcohol until you are feeling better.Drinking alcohol can slow down your recovery and make it more difficult to recover from a previous injury.

  • Write down things you have trouble recalling.

  • Talk with someone you trust before making important decisions.

General summary

  1. An intracranial hematoma is bleeding in the brain A subdural hematoma completely opposite to the intracranial hematoma is a bleeding below the dura which occurs in between the brain and the skull The main cause of this type of bleeding are head injuries that occur due to car accidents falls and other head trauma.

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