Hematomas: Causes and Treatments

A hematoma is a collection of blood outside the blood vessels, usually caused by a traumatic injury to the tissue. Hematomas can occur in different parts of the body and their severity can vary. Understanding the causes, types, and treatments of hematomas is very important for proper medical care.

What is a Hematoma?

A hematoma is essentially a pool of clotted or partially clotted blood that forms outside the blood vessels, often appearing as a visible hematoma lump. This happens when a blood vessel ruptures and blood leaks into the surrounding tissues. It can occur due to trauma, surgery, or certain medical conditions.

Hematomas are classified based on where they occur and which blood vessels are involved. The process of hematoma formation depends on the severity of the injury or underlying health condition.

Types of Hematomas

Hematomas happen when there is an injury that causes blood to pool outside the blood vessels. Accurate diagnosis and successful treatment depend on an understanding of the many types of hematomas. The following are a few of the most prevalent hematoma types:

Epidural Hematoma

An epidural hematoma forms between the dura mater (the outer membrane of the brain) and the skull. This type of hematoma is usually caused by head injury, leading to a tear in an artery, which causes rapid bleeding and increased pressure on the brain. Immediate medical attention is needed to prevent serious complications.

Subdural Hematoma

A subdural hematoma forms between the dura mater and the arachnoid mater (the second layer of the brain’s protective covering). This type typically occurs due to head injury, causing tears in the veins crossing the subdural space. Subdural hematomas can be acute, subacute, or chronic, depending on how quickly symptoms develop.

Intracerebral Hematoma

An intracerebral hematoma happens within the brain tissue itself. This type is often linked to severe head trauma or conditions such as high blood pressure and aneurysms. If not treated quickly, it can lead to significant brain damage.

Subungual Hematoma

A subungual hematoma forms beneath a fingernail or toenail, usually due to a crush injury. While not as severe as other hematoma types, it can cause considerable pain and may require medical attention to relieve pressure and prevent infection.

Subcutaneous Hematoma

A bruise, also referred to as a subcutaneous hematoma, develops immediately beneath the skin. This kind usually resolves on its own and is less severe. Larger subcutaneous hematomas, however, might need medical care.

Causes of Hematomas

Hematomas can occur due to various reasons, with the most common hematoma causes being:

Trauma

The most common cause of hematomas is trauma. A hematoma can grow as a result of blood vessels rupturing due to injuries like falls, auto accidents, or collisions during sports.

Surgical Procedures

Hematoma causes can also arise from surgical procedures. Post-surgery hematomas may occur if blood vessels are accidentally damaged during the operation or if proper hemostasis is not achieved.

Medical Conditions

Several medical conditions can increase the risk of developing hematomas, such as:

Medications

The risk of hematoma formation can be increased by certain treatments that interfere with blood coagulation, such as anticoagulants and antiplatelet medications. Patients on these drugs need to be constantly watched for bleeding symptoms.

Symptoms of Hematomas

The symptoms of a hematoma depend on its location and size. Common Hematomas symptoms include:

In cases of intracranial hematomas (e.g., epidural and subdural hematomas), additional symptoms may include:

Diagnosis of Hematomas

The diagnosis of a hematoma generally involves a combination of physical examination and imaging studies. To assess the severity of a hematoma and choose the best course of therapy, a comprehensive diagnostic is necessary. Typical diagnostic instruments consist of:

Physical Examination

A hematoma is diagnosed by taking a detailed history and thorough physical examination. The examination, which the physician will perform to check whether a hematoma has formed, will involve checking for blood accumulation in the affected area as if there is tenderness, discoloration and swelling in that area.

Imaging Studies

Imaging studies are often required to confirm the hematoma diagnosis and assess its extent. The most common imaging methods include:

Treatment Options for Hematomas

The treatment for hematoma depends on its type, location, and severity. Here are some common hematoma treatment options:

Conservative Management

For minor hematomas, conservative management may be enough. This includes:

Medical Intervention

For more severe hematomas, medical intervention may be required. This can include:

Hematoma Surgery

Surgical intervention may be necessary for certain types of hematomas, particularly intracranial hematomas. Surgical options include:

The choice of surgical procedure depends on the location and size of the hematoma, as well as the patient's overall health.

Preventing Hematomas

While not all hematomas can be prevented, certain measures can reduce the risk:

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Hematoma vs Bruise

Hematomas and bruises are both caused by trauma but differ in severity. A hematoma is a deeper, raised swelling filled with blood, often more painful, while a bruise is a flat, discolored patch on the skin that heals faster. Knowing these differences helps in proper treatment.