Hematoma – how it differs from hemorrhage

Hematoma is a certain amount of blood, usually clotted outside the blood vessels, which is most often caused by an injury to the wall of a blood vessel, which allows the blood to leak out of it in tissues not adjacent to the circulatory system.

The damaged blood vessel can be an artery, vein, or capillary, and the bleeding can be as small as a drop, or as large as a hemorrhage that causes significant blood loss.

This is a type of internal bleeding that contains clotted blood or subsequently forms clots.

Hemorrhage is a term used to describe heavy bleeding and is often classified as leaking 15-40% of the total amount of blood in the body.

Hematoma describes bleeding where the blood has already begun to clot.

However, the difference is sometimes not clear because hematomas enlarge over time and active bleeding can increase their mass.

Hematoma – what distinguishes it from hemorrhage

What are the symptoms

The amount of blood outside a blood vessel causes irritation and inflammation, with clinical manifestations depending on its location and whether the associated swelling and inflammation affect the surrounding tissues.

The most characteristic symptoms of inflammation are redness, pain and swelling.

In most cases, hematomas resolve on their own over time. The initial solid structure of clotted blood gradually becomes porous and soft and is gradually broken down by the body.

The shape changes as the fluid drains and the swelling due to the hematoma subsides.

The color changes from a purple-blue, bruise-like appearance, to yellow and brown. Chemicals from the blood are gradually absorbed and the hematoma resolves on its own.

Depending on its location, the characteristic coloration of the skin can cover various tissues under the action of gravity.

For example, a hematoma on the forehead may lead to bruising under the eyes that appears to move down to the neck and fade over time.

Hematomas occur frequently and in most cases are of no clinical significance.

However, if they are too large and are in certain places on the body such as the brain, they may be life-threatening.

What are the causes of hematomas

They are usually due to trauma, whether from a car accident, a mild blow, a cough, or an unknown event.

Blood in blood vessels is constantly moving and therefore does not clot or coagulate.

When blood leaves the circulatory system and stops moving, it almost immediately begins to clot.

Unless one is taking anticoagulants that prevent blood clots from forming such as aspirin, warfarin, clopidogrel and dipyridamole.

The more intense the internal bleeding, the larger the hematoma is formed.

Hematoma Treatment

Most skin collections of blood are due to injury and are treated by bed rest, application of ice packs and, if possible, compression of the affected area.

If the hematoma is on the leg, it is recommended to keep it higher than the heart for a longer time to reduce swelling.

Bleeding reduces over time. Depending on the location, immobilizing the affected area can speed up the healing process.

To control pain and inflammationit is recommended to use standard over-the-counter medications such as paracetamol and ibuprofen.

It is important to know that even standard painkillers have side effects and it is not recommended to use them for a long time without medical advice.

Hematoma of the brain

A more special type of hematoma that requires the appropriate attention. Brain hematomas are a frequent consequence of head trauma.

After receiving such injuries, few people go to the doctor, and the truth is that even if they do, they will most likely not pay attention to them since they do not have the characteristic symptoms.

Types and symptoms of cerebral hematoma

Cerebral hematomas are bleeding in the tissues of the organ, resulting in the formation of a cavity filled with blood.

The main symptom of hematomas – one or more in the brain – is an intense headache, which can cause nausea and constant vomiting.

Characteristic symptoms of hematomas in the brain

  • Vertigo;
  • Constant drowsiness;
  • Feeling sick;
  • Difficulties with coordination of movements;
  • Distortion of gait ;
  • Speech disorders of varying severity;
  • Significant difference in the size of the pupils from each other;
  • Sudden weakness in the limbs or on one half of the body.

Particular attention should be paid to babies and the elderly, as hematoma can occur in them, even after minor blows to the head.

Cerebral hematoma is a dangerous injury, as it leads to defects in the nervous tissue, impaired blood circulation in it, and an increase in intracranial pressure.

That is why it is very important to seek medical help in a timely manner, otherwise a lot of blood will accumulate in the brain, which will lead to displacement of the cranial structures relative to each other.

The result is deterioration of the person’s condition, development of seizures and convulsions, even 2 years after the trauma, lethargy, coma and even death.

The types of blood pooling in the brain:

  1. Subdural hematoma develops when the integrity of the blood vessels between the substance of the brain and its dura is violated. As a result of the hemorrhage in the tissue, a hematoma is formed, pressing on the brain. It is possible to gradually increase, leading to a slow loss of consciousness of the victim and the development of severe, sometimes irreversible destructive changes in the brain. Such hematomas can appear both immediately and several days and even months after the trauma.
  2. An epidural hematoma is formed as a result of a tear between the skull and the dura mater, which is often observed in skull fracture sustained in a car accident. With such traumas, the victims are rarely conscious.
  3. Intracerebral – it is localized only in the tissues of the brain and does not go beyond its limits.

Small subdural or epidural hematomas are usually treat conservatively.

Conservative therapy – this is:

  • Applying ice to the affected area;
  • Applying a compression bandage;
  • Prescribing physiotherapy;
  • Carrying out symptomatic treatment consisting of in taking painkillers, corticosteroids, neuroleptics, antiemetics;
  • Conducting anfibrin therapy in order to prevent repeated bleedings;
  • Prevention of the formation of brain edema
  • strong> with the help of diuretics;
  • Intake of preparations that improve blood microcirculation.

Intracerebral hematoma can also sometimes be treated conservatively, under constant control of the intracranial pressure.

Surgical treatment of brain hematoma

If a large hematoma has formed in the brain, it cannot be done without surgical treatment, which consists in removing the blood from the site , in which it has accumulated. Sometimes more extensive surgery is required when the bleeding inside the brain does not stop.

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