Intracranial Hematoma – Symptoms and Causes
Overview
An intracranial hematoma happens when blood collects inside the skull. This blood can gather within brain tissue or between the brain and skull, creating pressure on the brain.
The most common causes are burst blood vessels in the brain or head injuries from accidents like car crashes or falls.
While some head injuries might be minor, intracranial hematomas are serious medical emergencies that can threaten a person’s life. When someone develops this condition, they typically need immediate medical attention.
Common causes:
- Burst blood vessels
- Head trauma from accidents
- Falls with head impact
Treatment options usually include immediate medical intervention. Surgery is often necessary to remove the collected blood and relieve pressure on the brain.
Signs and Symptoms
Intracranial hematomas may show symptoms right after a head injury or take weeks to appear. Sometimes, there’s a period with no symptoms after the injury, called the lucid interval.
As pressure builds in the brain, you might notice:
- Worsening headache
- Vomiting
- Increasing drowsiness and reduced consciousness
- Dizziness or balance problems
- Confusion or disorientation
- Uneven pupil sizes
- Slurred or difficult speech
- Weakness or paralysis on the opposite side of the injury
If bleeding continues, additional symptoms can develop:
- Extreme sleepiness or sluggishness
- Seizures
- Complete loss of consciousness
Medical Attention Needed
An intracranial hematoma can be life-threatening and requires emergency care.
Get immediate medical help after any head injury if these symptoms appear:
- Any loss of consciousness
- Persistent headache
- Repeated vomiting
- Weakness in limbs
- Blurred vision
- Balance problems
It’s important to monitor someone with a head injury even if they seem fine at first. A person might appear normal and able to communicate but later become unconscious – this requires immediate medical attention.
If you’ve had a head injury, ask someone to keep an eye on you. Memory problems after head trauma might make you forget about the injury itself. Having someone watch for warning signs increases the chance of getting timely medical care if your condition worsens.
Causes
Head injuries are the main reason for bleeding inside the skull. Car crashes, falls, fights, and sports can all lead to these injuries. Even mild bumps can cause bleeding in older adults, especially those taking blood thinners.
You don’t need to have an open wound or bruise to have bleeding in your brain. The type of brain bleeding depends on where it happens.
Bleeding Below the Outer Brain Layer
This happens when blood vessels break between the brain and its protective outer layer (dura mater). The leaked blood forms a collection that pushes against brain tissue.
As this blood pool grows, it can make you lose consciousness and might be fatal.
There are three types:
- Quick-forming: Usually from severe head trauma with symptoms appearing right away.
- Medium-forming: Takes days or weeks for symptoms to show after injury.
- Slow-forming: Results from minor head injuries with bleeding that happens slowly over weeks or months.
You might not even remember hitting your head. Something as simple as bumping your head while getting into a car can cause bleeding, especially if you take blood thinners.
All types need medical help as soon as symptoms appear to prevent lasting brain damage.
Bleeding Above the Outer Brain Layer
This occurs when a blood vessel bursts between the skull and the brain’s protective covering. Blood collects between these areas and presses on brain tissue. Head injuries typically cause this type of bleeding.
Some people stay conscious with this condition, but most become sleepy or fall into a coma immediately after injury. If this bleeding affects an artery, it can be deadly without quick treatment.
Bleeding Within Brain Tissue
This happens when blood pools directly in brain tissues. Several things can cause this:
- Head injuries (which may cause multiple bleeding areas)
- Burst blood vessel bulges (aneurysms)
- Blood vessel problems present from birth
- High blood pressure
- Brain tumors
- Certain diseases that cause sudden bleeding in the brain
The symptoms and treatment depend on how much bleeding occurs and where it happens in the brain.
Risk Factors
Head injuries are a common cause of intracranial hematomas. People who ride motorcycles or bicycles without helmets face higher risks of developing these conditions.
Age plays a significant role in subdural hematoma risk, with older adults being more vulnerable. Other risk factors include:
- Daily use of blood thinners or aspirin
- Alcohol use disorder
Several medical conditions can increase the chance of intracerebral hematomas:
| Condition | Description |
|---|---|
| Arteriovenous malformations | Abnormal connections between arteries and veins |
| Aneurysms | Bulging blood vessels in the brain |
| Hypertension | High blood pressure |
| Brain tumors | Growths in brain tissue |
These conditions weaken blood vessels or create pressure in the brain, making bleeding more likely when injuries occur.
Ways to Avoid Head Injuries
Preventing serious head injuries that could lead to bleeding in the brain requires taking proper safety measures.
Use protective headgear correctly. Make sure you and your children wear well-fitted helmets during activities with a risk of head injury.
This includes contact sports, bike riding, motorcycling, skiing, horseback riding, and skateboarding.
Always use vehicle safety restraints. Buckle your seatbelt every time you travel in a vehicle.
Ensure children are properly secured in appropriate car seats or booster seats according to their age and size.
Create a safe environment for children:
- Add padding to sharp furniture edges and countertops
- Install safety gates on stairways
- Place guards on windows
- Secure heavy furniture and appliances to walls
- Keep children from climbing on unstable objects
These simple preventive steps significantly reduce the risk of head trauma that could result in dangerous bleeding inside the skull.
