Intracranial hematoma (ICH) refers to the accumulation of blood in the skull or brain usually due to the rupture of blood vessels and bleeding. The pooled blood creates pressure on the brain. Therefore, even in the absence of a visible external wound or bruise, there can be serious internal damage. ICH is a life-threatening condition that needs immediate treatment.
Based on the location of bleeding, ICH can be classified as follows:
Signs and symptoms can develop either immediately or after a few weeks from the occurrence of a blow to the head. The signs and symptoms are due to an increase in pressure on the brain and include the following:
As the condition worsens, the following signs and symptoms may appear due to narrowing of space between the brain and the skull:
Consult the doctor immediately if there is a persistent headache, unconsciousness, or problems such as vomiting, weakness, unsteadiness or blurred vision after a blow to the head.
The most common causes of intracranial hematoma are trauma or an injury to the head due to motor vehicle accidents, sports or falls. The other causes include high blood pressure, tumors, and malformations in the blood vessels.
Certain modifiable (lifestyle) and non-modifiable factors put a person at an increased risk of intracranial hematoma. They include:
It is sometimes challenging to diagnose ICH because the patient seems to be normal even after the head injury. In general, the doctor assumes hemorrhages inside the skull as the possible cause of unconsciousness and proceeds with the diagnosis.
Initially, the doctor recommends a CT scan to check for any abnormalities such as swelling or clotting in the brain. CT scan is the most commonly used imaging test to diagnose ICH as it gives quick results. Other imaging tests that may be required include an angiogram to identify the blood vessel problems and MRI scans.
The doctor may also perform a spinal tap or lumbar puncture to examine the cushioning fluid in the brain and the spine.
Intracranial hematoma needs emergency treatment. The outcome depends on the severity of hemorrhage and the promptness of treatment provided. The treatment approaches for ICH are as follows:
Often a surgery may be necessary to reduce the pressure on the skull associated with hematoma. The surgical options include:
Some patients may need physical or occupational therapy to carry out their normal activities.
The following measures can help to prevent the risk of intracranial hematomas especially associated with head injuries:
Geeta Dutta, a patient from West Bengal got in touch with Dr Venugopal Subramaniam, Consultant Neurosurgeon at Manipal Hospitals Whitefield through the OPD clinic programme and then later was guided by him towards a craniotomy & brain tumour removal.
Manika Saha, a patient from West Bengal got in touch with Dr. Venugopal Subramaniam, Consultant Neurosurgeon at Manipal Hospitals Whitefield through the OPD clinic programme and then later was guided by him towards a brain tumour removal in Whitefield, Bengaluru which gave her vision back.
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