Intracranial hematomas

[Ernesto]

Intracranial hematomas are accumulations of blood within the brain or between the brain and the skull.

Intracranial hematomas form when a head injury causes blood to accumulate within the brain or between the brain and the skull.
Symptoms may include a persistent headache, drowsiness, confusion, memory changes, paralysis on the opposite side of the body, speech or language impairment, and other symptoms depending on which area of the brain is damaged.
Computed tomography or magnetic resonance imaging is used to detect an intracranial hematoma.
Sometimes surgery is needed to drain blood from a hematoma.

Intracranial hematomas include

Epidural hematomas, which form between the skull and the outer layer (dura mater) of tissue covering the brain (meninges)
Subdural hematomas, which form between the outer layer and the middle layer (arachnoid mater—see Figure: Viewing the Brain)
Intracerebral hematomas, which form within the brain

After injury, bleeding can also occur between the arachnoid mater and the inner layer (pia mater). Bleeding in this area is called subarachnoid hemorrhage. However, because subarachnoid blood usually does not accumulate in one place, it is not considered a hematoma.
For people who are taking aspirin or anticoagulants (which increase the risk of bleeding), particularly older people, the risk of developing a hematoma after even a minor head injury is increased. Intracerebral hematomas and subarachnoid hemorrhages can also result from strokes.
Most epidural and intracerebral hematomas and many subdural hematomas develop rapidly and cause symptoms within minutes. Large hematomas press on the brain and may cause swelling and herniation of the brain. Herniation may cause loss of consciousness, coma, paralysis on one or both sides of the body, breathing difficulties, slowing of the heart, and even death.
Some hematomas, particularly subdural hematomas, may develop slowly and cause gradual confusion and memory loss, especially in older people. These symptoms are similar to those of dementia. People may not remember the head injury.
Diagnosis of intracranial hematomas is usually based on results of computed tomography (CT).
Treatment of intracranial hematomas depends on the type and size of the hematoma and how much pressure has built up in the brain.