April 13, 2009

Symptoms, Treatment & Prevention of Brain Hematoma

Posted in Category : Hematoma

The collection of blood under the skin or inside any organ is known as a hematoma. The collection of blood occurs when the blood vessels get ruptured. A hematoma can occur in any part of the body. However, if the condition develops inside the brain, it is known as a brain hematoma and is the most serious kind of hematoma.

The bleeding of an artery or vein in the brain tissue is known as intracerebal hematoma. Brain hematoma can occur in any part of the brain, and based on the location, it can be classified. The space located between the dura mater, the outermost of the three membranes covering the brain and spinal cord is known as subdural space. Outside of the dura mater is known as epidural space. If the hematoma occurs over the surface of the frontal lobes, it is called a subdural hematoma. This happens when the vessel carrying unoxygenated blood bleeds outside the brain. The damage of arteries causes epidural hematomas. A head trauma or a stroke can lead to a brain hematoma. If the hematoma causes severe pressure, it may even lead to death.

The symptoms of brain hematoma include the following:

  • Vomiting
  • Nausea
  • Dizziness
  • Severe headache
  • Loss of consciousness
  • Death
  • Coma
  • Visual disturbances
  • Weakness
  • Confusion
  • Slurred speech

Types of Hematomas and Causes

A brain hematoma may be a subdural hematoma, an epidural hematoma, or an intraparenchymal hematoma.

Subdural Hematoma: Blood collects under the skull but outside the brain. The collection of blood on the surface of the brain is called subdural hematoma. There are three types of subdural hematomas, namely, acute, sub-acute and chronic. An acute subdural hematoma maybe caused by a severe head injury.  In this condition, the bleeding fills the brain rapidly and may lead to death. The manifestation of the symptoms of a sub-acute hematoma is not immediate. A minor head injury can cause a chronic subdural hematoma. This can occur when the veins between the surface of the brain and its outer covering get stretched or ruptured. The symptoms may manifest slowly, and patients may not even recall injuring their head.

Head injury is the prime cause of a subdural hematoma. Other causes include the following:

  • Repeated head injury
  • Recurrent falls
  • Very old age
  • Medications such as blood thinners
  • Excess alcohol intake

Epidural Hematoma: The bleeding between the inside of the skull and the outer covering of the brain is called epidural hematoma. Skull fractures and severe head injury caused by accidents are the most common causes of an epidural hematoma. Since epidural hemorrhage leads to permanent brain damage, this kind of hematoma should be considered an emergency situation. It can lead to coma and death due to rapid worsening within minutes. The distinctive symptom of an epidural hematoma is a lucid interval. People suffering from this condition lose consciousness, followed by alertness, and again lose consciousness. For a shorter period, the person awakes from the coma stage. Immediate medical attention and quick diagnosis is very important as just for a few hours, a person’s life may be on the line.

Intraparenchymal Hematoma: Blood pools in the brain causes this condition. Generally, a head trauma is the cause for intraparenchymal hematoma. However, there are other causes that include:

  • Blood vessel disorders
  • Brain tumors
  • Autoimmune diseases
  • Use of blood thinners
  • Bleeding disorders
  • Drugs like cocaine

Brain herniation, coma, persistent memory loss, dizziness, seizures, difficulty in speaking, numbness, and weakness are some of the complications of brain hematoma.


The treatment of a hematoma depends on the location and type of hematoma. Depending on the severity and damage of the brain, a subdural hematoma can be treated by locating the hematoma and conducting a surgical evacuation. The treatment consists of lowering the pressure within the brain. Tiny hematomas are reabsorbed by the body and require no treatment. If the hematomas do not disappear on their own, then surgical procedure is required.

The presence of a hematoma within the soft tissue of the brain is a medical emergency. For localized blood pooling, a surgical drainage procedure is used. A neurosurgeon will drill a small opening in the skull and, with the use of suction, will remove the accumulated blood. If there is a large hematoma that occurs in the dura, a craniotomy is required to remove the blood.

Depending on the severity of symptoms, in addition to surgery, medications are prescribed. To prevent seizures, anticonvulsant medications are prescribed. To reduce brain swelling, medications and hyperosmotic agents are used.


Head injury is the prime cause of brain hematomas. It is vital to minimize the risk of head injury by using appropriate safety equipments like helmets, seat belts, etc. It is also vital to take appropriate safety precautions during activities like sports, recreation, and at work. Elder people should be careful to avoid falls.


  1. http://www.nlm.nih.gov/medlineplus/ency/article/001412.htm
  2. http://www.nlm.nih.gov/medlineplus/ency/article/000713.htm
  3. http://www.umm.edu/ency/article/000713trt.htm