Brain Hematoma: An Overview of the Disease Process

When one sustains head injuries or head trauma because of car accidents, falls, or inflicted by another individual by hitting that person with a solid and hard object forcefully, then that person could suffer from subdural hemorrhage which could lead to bleeding and accumulation of the blood in the affected area such as the subdural space of the brain; this condition is known as brain hematoma.

The main classifications of brain hematoma are:

  • Subdural Hematoma – This condition is due to the rupture of the blood vessels specifically the veins located between the brain and the outermost layer of the membrane which is the dura mater.
  • Epidural Hematoma – This is also referred to as extradural hematoma. This condition occurs when an artery between the skull and the dura mater has ruptured.
  • Intraparenchymal Hematoma – this is more popularly known as the intracerebral hematoma; this happens when a head injury is sustained and the blood accumulates in the brain.

Sustaining brain hematoma is a serious life-threatening condition which could cause serious damage and pressure to the surrounding brain tissues; compression pressure on the soft surrounding tissues of the brain further increases the intracranial pressure which could cause more severe and detrimental problems if the pressure gets extremely elevated. The increased pressure on the brain tissues can be really fatal especially when prolonged.

The three major types of subdural hematoma are:

  • ACUTE. This type of subdural hematoma is the most fatal of all the types because it is most commonly caused by a strong and forceful blow on the head causing severe head injuries. In this type, the signs and symptoms appear abruptly right after the trauma.
  • SUBACUTE. When head trauma occurs, the signs and symptoms may not be noticeable right away and can be apparent after a few days or a few weeks.
  • CHRONIC. This type of subdural hematoma is caused by a far less severe type of head trauma compared to the first two types. Since the bleeding is at a slower pace, the individual might not recall the trauma having hit or injured his head before the signs and symptoms become evident after a few weeks.

All of these types of brain hematoma necessitate immediate medical attention even before any symptoms are manifested by the injured person because ignoring it may cause permanent and irreversible brain damage.

Some people are more at risk for the worst cases of brain hematoma; here are some of the risk factors that may predispose an individual to developing fatal subdural hematomas:

  • People who have been taking anti-coagulant drugs or blood thinners such as aspirin
  • Abusive and long-term consumption of alcoholic beverages
  • People who have experienced repetitive falls
  • People who have sustained previous and frequent head injuries or trauma
  • Age is also a very important factor and the most prone are:
  • Very young because their brain have not fully grown so they have a much bigger subdural space;
  • Very old people are also at risk for developing severe brain hematoma cases because, as people age, the brain gradually shrinks allowing more space in the subdural area and because blood vessels have also become more fragile.

For people who have a clearer idea as to what danger signs they should look out for to prompt urgent medical attention; here are some of the significant signs and symptoms:

  • Infants:
  • Swollen or bulging fontanelles
  • Vomiting
  • Lethargy
  • Irritability
  • Frequent high-pitch cry
  • Seizures
  • Noticeable increase in head circumference
  • Visible separation of skull bone sutures
  • Coma
  • Adults:
  • Confusion
  • Slurring of speech/Speech difficulties
  • Severe headache
  • Nausea and vomiting
  • Generalized body weakness
  • Dizziness
  • Apathy
  • Extreme drowsiness
  • Behavioral changes
  • Coma

Diagnosing Subdural/Brain Hematoma

After sustaining head trauma or injury, it is best to seek professional medical help, undergo diagnostic examinations, and complete physical assessment. Prognosis is better when diagnosed at a much earlier time. In confirming the diagnosis if a patient has brain hemorrhage, one has to undergo the Computerized Axial Tomography Scan. The CT SCAN provides data from multiple X-ray images which reveals even the soft tissues and minute structures in a particular area in the body because it could make these images 100 times clearer which could not be visualized using a simple X-ray machine.

Angiography may also be considered in diagnosing this condition, but this is rarely used. Angiogram is done by inserting a catheter into a major artery; the next step would be introducing a dye by injecting it into the special catheter while viewing the flow of the dye under an X-ray screen. Through this procedure, they will be able to locate where the bleeding is coming from.

MRI or the so-called Magnetic Resonance Imaging is the best diagnostic evaluation tool in confirming the exact location of the brain hemorrhage and hematoma as it provide a much detailed and clearer image by using a huge magnet and radio waves to create computer-generated images.

Treating Brain Hematoma

Brain hematoma in all circumstances should be considered a fatal emergency condition; in severe cases especially when a patient falls into a coma, emergency surgery may be the best option to eliminate the clots through a procedure called craniotomy. Removing the clots will also help reduce the intracranial pressure.

After the surgery, there may still be a need to prescribe the patient with steroids and diuretics to reduce the inflammation. To prevent seizures, doctors may also give these patients anticonvulsants.

Rehabilitative Therapy is also one best option to restore the muscle tone and strength of these patients so they could go back to some of their usual activities and be a functional member of the society once again after the sustaining a life-threatening brain hematoma.