Intracranial hematoma: causes, diagnosis, treatment and consequences

Headache is one of the most common symptoms among the adult population. It is less common in children. Headache can be associated with various diseases, as well as with changing weather conditions, atmospheric pressure, stress, etc. The cause of this symptom is any intoxication (inflammatory pathologies, poisonings, infections), neurological disorders, trauma, migraine. People often do not pay attention to the headache, getting used to it and considering it not dangerous. This is not true. In some situations, this symptom is very serious. He can testify, for example, about such pathology as intracranial hematoma. Often, its appearance is associated with head trauma. But there are other reasons for its development.

What is intracranial hematoma?

Symptoms that occur with intracranial hematoma develop due to compression of the brain with blood. The absence of treatment can lead to serious damage to the central nervous system. The danger of the disease is that the signs of pathology occur gradually.

So what is a hematoma inside the skull? Due to various reasons, there may be a hemorrhage from the vessels of the head. As a result, there is a so-called bruise in the meninges - a hematoma. Unlike hemorrhages in soft tissues and skin, it dissolves very slowly. Only small hematomas can disappear on their own. With medium to large hemorrhage, surgical intervention is necessary.

Causes of hematoma

It is necessary to know that hematomas in the envelopes or substance of the brain are the result of various diseases and injuries. In most cases, severe strokes on hard surfaces (floor, walls, ice), car accidents lead to the development of hemorrhage. In old age, the risk of developing intracranial traumatic hematomas is significantly increased. This is due to the weakness of the walls of the vessels located in the brain and its membranes.

But in some cases, intracranial hematoma is formed and in the absence of traumatic effects. This is due to the rupture of an aneurysm of blood vessels. Such a disease can be both congenital (malformation) and acquired. Aneurysm is formed as a result of the lack of treatment for hypertension.

Another reason for the occurrence of intracranial hematoma is a tumor of the brain or its membranes. To a hemorrhage result both benign neoplasms, and oncological processes.

The development of hematoma is also promoted by atherosclerotic lesions of cerebral vessels, infectious pathologies, a stroke or transient ischemic attack, angioedema disorders. The risk of hemorrhage develops in elderly people, smokers, people suffering from hypertension and obesity.

Varieties of intracranial hematomas

Depending on the size, small, medium and large hematomas are isolated. Also, intracranial hemorrhages are classified by flow and localization.

The volume of small hematomas is less than 50 ml. In some cases, they resolve themselves. If the amount of hemorrhage is from 50 to 100 ml, then it is called the average hematoma. They require surgical treatment. Hematoma, whose volume reaches more than 150 ml, can lead to death.

According to the clinical course, 3 types of hemorrhage are identified. Signs of acute intracranial hematoma are detected within 3 days of its formation. They are considered the most dangerous. Subacute hematomas are revealed within 3 weeks. Deterioration of the state occurs gradually. Chronic hemorrhage makes itself felt after 3 weeks from the time of their formation.

By localization, the following types of pathologies are distinguished:

1. Epidural intracranial hematoma. It is formed when the artery is damaged, located between the outer surface of the dura mater and the skull.
2. Subdural hematoma. The source of bleeding is the veins that connect the substance of the brain with the sinuses of the hard shell. Most often it has a subacute current.
3. Intracerebral hematoma. Such a hemorrhage is very dangerous. It develops due to the impregnation of the substance of the brain. Such a hemorrhage can cause irreversible damage to nerve cells.
4. Intracranial hematoma of the brain stem. This type of hemorrhage leads to death.
5. Diapedeznye hematomas. Develop due to increased permeability of cerebral vessels.

Depending on the location and source of hemorrhage, the clinical picture of hematomas may be different. Proceeding from this, the tactics of treatment are chosen.

Clinical picture of pathology

How to determine that intracranial hematoma was formed? Symptoms of pathology depend on the type of hemorrhage. So, to the signs of epidural hematoma include severe headache, convulsive syndrome, impaired consciousness and drowsiness. When studying the reaction of pupils to light, anisocoria is noted. Later, the paralysis of the extremities joins. Symptoms of intracranial hematoma are detected within a few hours or days from the time the artery is damaged. Children develop symptoms faster.

Subdural hematoma is characterized by the following clinical picture:

• Headache predominates;
• Nausea and vomiting, not bringing relief;
• Meningeal signs;
• Sometimes there are convulsive seizures.

The symptoms of intracerebral hemorrhage are similar. Unlike signs of subdural hematoma, pain covers one side of the head, loss of consciousness is noted. Intracerebral hemorrhage often leads to paralysis of the limbs.

Diapedeznye hematomas are characterized by constant headaches. Identify them is the most difficult, because they are small in size.

Diagnosis of a bruise inside the skull

Intracranial traumatic hematomas are diagnosed first of all, as in most cases people seek medical help after getting injuries. It is more difficult to detect hemorrhages arising on the background of vascular diseases. The methods of diagnosis include:

1. Computer tomography of the brain.
2. X-ray examination of the skull.
3. Magnetic resonance imaging.

For differential diagnosis of headaches, ultrasound of vessels with dopplerography, EEG, echoencephalography is performed.

Methods of treatment of the disease

Treatment of intracranial hematomas is carried out by conservative and operative methods. In the absence of complications and small hemorrhages, the doctor only observes the patient's condition. The patient should stay in the hospital and observe bed rest. If the hematoma does not resolve itself, prescribe drugs that reduce intracranial pressure. Symptomatic therapy is also provided. Assign medicines "Relanium", "Furosemide", "Ketonal".

Conducting surgical intervention

In most cases, operative removal of intracranial hematoma is indicated. It is the evacuation of blood. For this purpose, the following types of surgical interventions are performed:

1. Bone-plastic trepanation. Characterized by the creation of a small hole in the skull and removal of blood clots with special tools and a vacuum device.
2. Stereotactic interference. Blood from the cranial cavity is excreted by means of a special cannula.
3. Puncture-aspiration removal of the hematoma. It is in the formulation of a thin catheter.

The method of surgical treatment is selected by a neurosurgeon, depending on the size of the hemorrhage, the accompanying pathologies and the patient's age.

Intracranial hematoma: consequences of the disease

The consequences of hematoma include such clinical manifestations as posttraumatic convulsions, amnesia, headache and general weakness. These symptoms can be observed for several months. Therefore, rehabilitation takes about six months. If surgery is not performed on time, hematoma can lead to paralysis, brain edema and death.