The brain floats within the skull and is surrounded by fluid that cushions it from any impact. However, this fluid may not be able to protect the brain from a sudden blow, resulting in brain injury. One such injury is known as intracranial hematoma. A Hematoma, is a collection of blood outside the blood vessels. An intracranial hematoma is the collection of blood between the brain and skull. Such a hematoma leads to compression of the brain tissue.
The symptoms of an intracranial hematoma may occur immediately after the impact or may manifest several weeks after. As time progresses, the pressure on the brain increases, and consequently, the symptoms usually worsen. Intracranial hematomas can be diagnosed using computed tomography or MRIs – Magnetic Resonance Imaging. There are different types of intracranial hematomas. These include epidural hematomas, which form between the skull and the dura mater (outer layer of tissue covering the brain); subdural hematomas, which form between the dura mater and the arachnoid mater (middle layer of tissue covering the brain) and intracerebral hematomas, which form within the brain. All types of hematoma usually exhibit the same symptoms.
As with most cases of head injuries, the symptoms include headache, nausea, vomiting, and dizziness. With low intracranial pressure, weakness in the limbs on one side of your body is normal. Pupils can be of unequal size and speech can be slurred. There have also been cases of loss of concentration and memory loss.
In cases of high intracranial pressure, the risk of herniation, where the brain shifts inside the skull, is high. Since herniation puts extreme pressure on parts of the brain while moving around, it is often fatal. Another risk of high intracranial pressure is seizures where neural activity is abnormal. Thus, intracranial pressure should be kept normal.
The best option for treatment for hematomas is surgery. With epidural hematomas, a perforation can be performed, in which the unclotted blood is removed by means of suction through a tiny hole drilled in the skull. Another option is a craniotomy, where part of the skull is removed to access the brain. Subdural hematomas are normally acute, and the blood gets absorbed on its own. In the case of intracerebral hematomas, direct damage is done to the brain and surgery is avoided as it does not restore brain functioning.
A patient who has sustained a head injury might develop an intracranial hematoma even when there are no abnormal clinical signs. Thus, in cases of head injury, a skull x-ray is always in order. Moreover, for people who are taking anticoagulants (substances that do not let blood clot), particularly older people, the risk of developing a hematoma after even a minor head injury is high.