Intracranial Hematoma – Diagnosis and Treatment
Head injuries are a common health concern that can happen to anyone, often caused by falls, motor vehicle accidents, or direct trauma. These injuries include a range of conditions such as concussions, skull fractures, and brain injuries.
Some cases involve damage to the dura mater, the tough outer layer covering the brain, while others may result in a contusion or bleeding within the brain tissue.
Traumatic brain injuries (TBI) can vary from mild to severe. Conditions like diffuse axonal injury, penetrating injuries, and basilar or depressed skull fractures are serious and can have lasting effects.
Understanding the ways head trauma can occur and the different types of injuries helps improve prevention and care.
Finding the Cause
Doctors look for symptoms such as headache, vomiting, nausea, confusion, dizziness, seizures, or loss of consciousness. They perform a quick neurological exam to check for changes in alertness, movement, and response.
They also monitor blood pressure and look for signs of rising intracranial pressure like a sudden headache or altered behavior.
Imaging plays a main role in diagnosis. Doctors often use a CT scan first because it is fast and can show bleeding, brain swelling, or shifting of brain tissue.
MRI scans also help spot smaller bleeds, signs of brain edema, or possible areas of brain herniation. Both CT and MRI scans identify the exact size, position, and type of intracranial hematoma.
Table: Imaging Techniques for Intracranial Hematoma Diagnosis
| Test | What it Detects | When it is Used |
|---|---|---|
| CT Scan | Bleeding, swelling, tissue shifts | First-line emergency test |
| MRI Scan | Smaller bleeding, edema, herniation | Detailed follow-up imaging |
| Angiogram | Blood vessel issues, aneurysms | Specific cases |
Sometimes, doctors also review cerebrospinal fluid to determine if infection or other causes need to be ruled out. Quick and accurate diagnosis using these methods guides effective treatment.
Treatment
Medical Procedures
Doctors treat brain bleeds, like subdural or epidural hematomas, by removing the blood to lower pressure on the brain. The best approach depends on the type and size of the bleed.
For some, doctors make a small opening in the skull to use suction and remove liquid blood. In cases with bigger clots or solid hematomas, they may perform a craniotomy, temporarily removing a larger part of the skull to clear the blood.
Blood thinners, such as warfarin, can increase bleeding risk. Medical teams may use vitamin K or plasma to reverse the effects. They may also give medicines like mannitol or hypertonic saline to help control swelling in the brain.
If there is a risk of seizures, doctors prescribe anti-seizure drugs such as phenytoin.
Patients with subarachnoid hemorrhage may receive nimodipine to lower the risk of blood vessel spasms. Teams monitor the patient’s condition and repeat brain scans during treatment.
Healing and Aftercare
Recovery after removal of an intracranial bleed varies for each person. Most improvement happens in the first six months. Some people may need ongoing physical, speech, or occupational therapy to regain skills and strength.
The table below lists common supportive therapies:
| Therapy Type | Purpose |
|---|---|
| Physical therapy | Improve movement and strength |
| Occupational therapy | Help with daily activities |
| Speech therapy | Aid in speaking and swallowing |
Some effects, especially from chronic subdural hematomas, can last for months. Some patients may not recover all abilities. Continued follow-up care from neurology and rehabilitation teams supports the best outcome.
Managing Recovery and Getting Help
Recovering after a brain injury such as an intracranial hematoma often takes time and patience. Most of a person’s progress is seen in the first six months, but smaller improvements can still happen up to two years later.
Each person’s experience is different, but certain steps can make the recovery journey safer and easier.
Rest and Sleep
- Get enough sleep each night.
- Rest during the day if feeling tired.
Return to Activities
- Start normal activities slowly, based on how strong a person feels.
- Avoid sports or activities that could cause more harm until a doctor approves.
- Only drive, ride a bike, or use machines when the health team says it is safe.
Health and Medicine
- Always check with healthcare professionals before taking any medications.
- Stay away from alcohol until fully healed, as alcohol can make recovery slower and increase the chance of another injury.
Daily Support Strategies
- Write down tasks and reminders if having trouble remembering things.
- Speak to a trusted person before making big decisions.
- Keep a regular daily routine to make things more manageable.
Home Care and Rehabilitation
People recovering from a brain injury may need help at home and support from rehabilitation services. The following table lists common areas and types of help that support recovery:
| Area | Support Example |
|---|---|
| Physical Activities | Physical therapy, gentle exercise |
| Memory and Thinking | Memory aids, reminders, routine |
| Emotional Support | Talking to friends, support groups |
| Daily Tasks | Assistance with cooking or dressing |
| Rest and Sleep | Quiet space for naps and sleep |
Family and friends can help by setting reminders, watching for signs of trouble, and being patient during recovery. Support groups, whether in person or online, offer advice and emotional encouragement.
If help is needed with activities or feelings, professionals like nurses, therapists, or counselors can provide extra support.
Making small changes in the home can also help. Minimize noise and distractions, use notes or alarms, and create a simple schedule to help those with brain injuries feel safer and less confused.
