Hematomas

What are Haematomas?

A haematoma refers to the pooling of blood outside blood vessels, commonly caused by trauma. When occurring in the brain, haematomas are classified based on their location relative to the skull and brain tissues. These types subdural, extradural, and intracerebral haematomas can cause significant pressure on the brain, leading to life-threatening complications if not treated promptly.

Types of Haematomas

Haematomas in the brain are categorised into three main types:

1. Subdural Haematoma:

   • Occurs beneath the dura mater (the outer protective membrane of the brain).

   • Commonly caused by a head injury that tears veins bridging the brain and dura.

   • Can be acute, subacute, or chronic depending on the onset and severity of symptoms.

2. Extradural Haematoma (also known as Epidural Haematoma):

   • Forms between the skull and the dura mater.

   • Often associated with a skull fracture that damages arteries, particularly the middle meningeal artery.

   • Typically has a rapid onset of symptoms, making it a medical emergency.

3. Intracerebral Haematoma:

   • Occurs within the brain tissue itself.

   • Can result from trauma, high blood pressure, or rupture of blood vessels.

   • May lead to extensive damage to brain structures due to the direct compression and swelling.

Symptoms of Haematomas

The symptoms of brain haematomas depend on the type, size, and location of the bleed. Common signs include:

• Severe headache

• Nausea and vomiting

• Loss of consciousness

• Seizures

• Weakness or numbness in limbs

• Difficulty with speech or vision

• Confusion or altered mental state

• Uneven pupils or difficulty moving the eyes

Diagnosis and Treatment Options

Diagnosis: The diagnosis of haematomas involves imaging studies and neurological assessment:

• CT Scan: Quickly identifies the location and extent of bleeding.

• MRI: Provides detailed imaging, especially for subacute and chronic haematomas.

• Neurological Examination: Assesses the impact on motor skills, cognition, and sensory function.

Treatment: Management depends on the type, size, and symptoms of the haematoma:

1. Subdural Haematoma:

   • Conservative Treatment: Observation for small, asymptomatic cases.

   • Surgery: Burr hole drainage or craniotomy to remove the clot and reduce pressure.

2. Extradural Haematoma:

   • Emergency Surgery: Craniotomy to evacuate the haematoma and repair damaged blood vessels.

   • Early intervention is critical to prevent fatal outcomes.

3. Intracerebral Haematoma:

   • Medical Management: Includes controlling blood pressure and reducing brain swelling with medications.

   • Surgery: Required for large haematomas causing significant pressure or damage.

Conclusion

Haematomas are serious conditions requiring prompt medical attention. Understanding the symptoms and seeking early evaluation can prevent severe complications. At Singapore Brain Spine Nerves Center, our team of specialists is equipped to diagnose and treat all types of brain haematomas, ensuring personalised and effective care. If you or a loved one are experiencing symptoms of a haematoma, consult a healthcare professional immediately for expert assistance.