Intracranial Hematoma

Intracranial Hematoma

Hematoma occurs due to bleeding in the skull. Accumulation of blood between the brain and skull is known as intracranial hematoma. It is of 3 kinds – epidural, subdural, intracerebral. Hematoma occurring between the outer layer of brain [duramatter] and the skull is epidural hematoma. Hematoma occurring between the outer layer of brain [duramatter] and middle layer [arachnoid matter] is subdural hematoma. Hematoma occurring within the brain is called intracerebral hematoma.

Causes and risk factors

Bleeding in the skull gives rise to hematoma. Hematoma occurs when there is rupture of blood vessels especially veins between the layers of brain or between skull and outer layer of brain. The blood that is accumulated creates pressure on the brain tissue. Large hematoma causes increased intracranial pressure leading to varied neurological signs and symptoms. Causes of intracranial hematoma include head injury, excessive alcohol intake, long-term use of anti-inflammatory drugs, blood thinning medications etc., diseases associated with reduced blood clotting, old age. Any cerebrovascular accident, haemorrhage in the skull results into intracranial hematoma.

Clinical presentation

Signs and symptoms depend upon the type of injury and size of hematoma. Many a times patient is asymptomatic. However patient may present with signs and symptoms like headaches, nausea, vomiting. Patient experiences visual difficulties like unequal pupils, speech difficulties such as slurred speech, difficulty in swallowing, difficulty in walking. There can be impaired memory, seizures confusion, dizziness, numbness or weakness in face, arms, or legs, lethargy, paralysis, and coma.

Investigation

Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Imaging studies such as CT scan, MRI is recommended which confirms the diagnosis.

Treatment

No treatment is required for small subdural hematomas. Medical treatment involves anticonvulsant drugs to prevent seizures, corticosteroid drugs to reduce inflammation, if patient is on blood thinning medicines reversing their effect is necessary.  Surgical intervention involves surgical drainage, craniotomy procedure. Prevention of recurrent hematomas is required by following some measures like restricting alcohol intake, taking long-term medications under regular medical supervision, taking safety precautions to prevent head injury.

Other Modes of treatment

The other modes of treatment can also be effective in treating intracranial hematoma.

Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating intracranial hematoma.

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