Intracranial hematomas are the most serious complications after brain injuries, e.g. as a result of an accident. Permanent body paresis, coma and even death can result from the accumulation of blood in the brain. Hematomas most often occur as a result of inertial injuries, i.e. those where there was a rapid change in speed, e.g. when hitting a head against a stationary obstacle. Find out what types of brain hematomas are and how to recognize if they have occurred.
Intracranial hematoma- also known as intracranial hematomas - is a hematoma formed in a limited area of the inside of the skull as a result of a head injury. Consequences of closed head injuries may be manifested in the form of pressure on the brain resulting from damage to the blood vessels within the skull and intracranial bleeding. Depending on the location of the formed hematoma in relation to the dura mater (one of the meninges) and the brain, epidural, subdural and intracerebral hematomas are distinguished.
Epidural hematoma
Epidural (epidural) hematomais a bleeding into the space between the skull bone and the dura mater. With every minute, the amount of blood in the epidural space increases and more pressure is exerted on the brain, which in turn causes the meningeal artery to rupture. A characteristic symptom of epidural hematoma is the so-called brightening of consciousness, i.e. initially the patient loses consciousness, then I regain it for several dozen minutes (or even several hours), and then faint again. The build-up of epidural hematoma is also accompanied by other symptoms, such as:
- pupil dilatation on the side of the lesion,
- paresis of the paravomotor nerve and increasing paresis of half of the body (usually preceded by Jackson-type convulsions (the so-called seizure march - convulsions are limited to only some muscle groups. corners of the mouth to the middle of the face),
- nausea,
- vomiting,
- fracture of the skull bone in the temporal-parietal area.
Patients with epidural hematoma require immediate surgical treatment. Failure to do so may result in a cerebral coma. If the hematoma is small, it is enough to lie down and take preventive medicationsbuild-up of intracranial pressure. However, in about half of the cases, a neurosurgeon's intervention and surgical treatment are required. Epidural hematoma is a complication of approximately 10% of severe head injuries.
Subdural hematoma
Subdural (subdural) hematomais caused by the accumulation of venous blood between the dura mater and the arachnoid (arachnoid), which can break the veins in the brain. It occurs most often in very severe head injuries, mainly in those where the bones of the skull were fractured.
Its symptoms can vary greatly depending on the location of the hematoma. These include headaches, paresis, speech and gait disturbances, drowsiness, impaired consciousness or epilepsy. Treatment is primarily based on surgical procedures. In turn, the treatment of complications in the form of paresis and speech disorders is the same as in the case of a stroke.
The consequence of brain contusion may also besubarachnoid hemorrhagewith the spilling of blood into the space between the arachnoid and dura mater. Symptoms are the same as in subarachnoid haemorrhage due to rupture of a brain aneurysm, i.e. sudden pain in the back of the head with vomiting, neck stiffness, often with loss of consciousness and convulsions, and impaired eye movement (paravermic nerve paralysis).
Intracerebral hematoma
Intracerebral hematoma -otherwise hemorrhagic stroke-accounts for approximately 20% of all traumatic hematomas. In this case, blood is collected in the brain, especially around the base of the frontal and temporal lobes.
Intracerebral hematoma formed in the cerebellum (in the back cavity of the skull) is especially dangerous, because it presses on the respiratory center of the brainstem, which is a direct threat to life.
Toof late effects of brain injuriesinclude: recurrent meningitis, encephalitis, brain abscess, post-traumatic epilepsy or post-traumatic syndrome.