Intracranial hematoma

The intracranial hematoma (blood tumor) represents accumulation of blood in a head cavity which reduces intracranial space and promotes a brain prelum. There are similar accumulations of blood as a result of a rupture of aneurism, injuries of vessels and hemorrhages – in a tumor, an infectious origin or as a result of a stroke.

Feature of an intracranial hematoma is that clinical manifestations arise not at once, and later some period.

The most important danger of an intracranial hematoma consists that she puts the essential pressure upon a brain. As a result wet brain with defeat of brain fabric and its subsequent destruction can be formed.

Types of intracranial hematomas

Hematomas happen:

• acute – symptoms are shown for 3 days from the moment of education;
• subacute – symptoms are shown for 21 days;
• chronic – manifestation of symptoms occurs after 21 days from the moment of education.

By the sizes distinguish small hematomas (to 50 ml), averages (50-100 ml) and big (it is more than 100 ml).

In the place of localization of a hematoma subdivide on:

• epidural, being over a firm cover of a brain;
• subdural, with localization between substance of a brain and its firm cover;
• intracerebral and intra ventricular which place of localization is the share directly of brain substance;
• intracranial hematomas of a trunk of a brain;
• the diapedetic hematomas resulting from hemorrhagic treatment, at the same time integrity of vessels it is not broken.

Main reasons for developing of an intracranial hematoma

The disease or injury is the main reason for an intracranial hematoma.

So, subdural hemorrhage often results from a rupture of the veins connecting a brain and venous system, and also sine of a firm cover of a brain. The hematoma which squeezes brain tissues is as a result formed. As blood from a vein collects slowly, symptoms of a subdural hematoma can not be shown for several weeks.

The epidural hematoma is usually formed as a result of a rupture of an artery or a vessel between a skull and an external surface of a firm cover of a brain. In arteries pressure of blood is higher, than in veins therefore blood follows from them quicker. The epidural hematoma quickly increases in sizes and strengthens pressure upon brain fabric. Symptoms are usually shown quickly enough, sometimes even within several hours.

The intracerebral hematoma is formed as a result of penetration into a blood brain. If the hematencephalon results from getting injured, then white matter of a brain preferential is surprised. Such damage is resulted by a rupture of neurites which cease to transfer impulses in different parts of a body. The intracerebral hematoma can be formed also as a result of a hemorrhagic stroke. In this case hemorrhage comes from unevenly thinned wall of an artery and blood under high pressure gets to tissues of a brain and fills free space. Such hematoma can be formed on any site of a brain.

Thinning and ruptures of vessels result, as a rule, from tumors, infections, angioneurotic disturbances, atherosclerotic defeats, etc.

There can sometimes be diapedetic hemorrhages resulting from a hyperpermeability of vessels (at change of coagulant properties of blood or a fabric hypoxia). It leads to formation of accumulations of blood around the damaged vessels which often combine, and the intracranial hematoma is formed.

Symptoms of an intracranial hematoma

Often symptoms of an intracranial hematoma are shown later a certain period. The main symptoms depend on the nature of an intracranial hematoma and its size. As the hematoma preferential develops as a result of traumatic damage, and symptoms generally prevail, characteristic of injury of a brain. Besides, the symptomatology of a hematoma can differ depending on age of the patient.

At an epidural hematoma symptoms are shown quickly. Patients are tormented by a severe headache, drowsiness, confusion of consciousness. Often patients with an epidural hematoma fall into coma. At formation of a hematoma more than 150 ml of people dies. The progressive mydriasis on the party of a hematoma is noted. To the patient there can be epileptic seizures, paralyzes and the progressing paresis. At children symptoms of an epidural hematoma have the following character: there is no primary loss of consciousness, hypostasis develops very quickly and demands immediate operational treatment of an intracranial hematoma.

At formation of a subdural hematoma symptoms, as a rule, are not shown at once, and initial defeat seems insignificant. Usually symptoms begin to be shown several weeks later. At small children increase in the head in sizes can be observed. At patients of old age the subacute course of a hematoma is observed. Young patients feel a headache, in the subsequent vomiting and nausea, epileptic seizures and spasms can develop. The mydriasis from damage can be noted, but not always. Small intracranial hematomas can independently resolve, and big hematomas need emptying.

At an intracerebral hematoma as a result of a hemorrhagic stroke the symptomatology depends on the defeat center. The most frequent symptoms are a headache (preferential on the one hand), hoarse breath, a loss of consciousness, and also paralysis, spasms and vomiting. At defeat of a brainstem treatment of an intracranial hematoma is impossible, and the patient dies.

At an intracranial hematoma which was formed owing to an extensive injury, symptoms, as a rule, such: headache, loss of consciousness, vomiting, nausea, epileptic seizures, spasms. It is usually possible to define localization of such hematoma only as a result of an operative measure.

At formation of a hematoma owing to a rupture of aneurism the main symptom is acute and sharp pain in the head (as blow of a dagger).

Treatment of an intracranial hematoma

Preferential treatment of an intracranial hematoma assumes an operative measure. The type of operation often depends on the nature of a hematoma.

After carrying out operation the doctor appoints anticonvulsant medicines for prevention or control of posttraumatic spasms. Sometimes, that similar spasms begin at the patient even a year later after getting injured. For some time at the patient amnesia, a headache and disturbance of attention is possible.

The recovery period after an intracranial hematoma usually very long. The period of recovery takes, at least, half a year adult patients. Children are, as a rule, recovered much quicker.