MedClinic > Blog > Neurosurgery > Intracerebral hematoma

Intracerebral hematoma

An intracerebral hematoma is a serious disease that occurs due to hemorrhage in the brain tissue. Even though most people do not take this phenomenon seriously, believing that everything will pass by itself, and that removal of intracerebral hematoma is not necessary, this can cause the development of irreversible pathological processes in the brain, which will entail disturbances in the functioning of the whole organism ( post-traumatic organic disorder, hydrocephalus, post-traumatic epilepsy, etc.).

An intracerebral hematoma is accompanied by a rupture of a blood vessel, and blood that flows out without ways outside begins to accumulate in the brain tissue (intracerebral hematoma) or the lumen between the brain and the wall of the cranium, then we are talking about an epidural or subdural hematoma.

Symptomatic picture

Depending on the severity of the injury, the symptoms of a hematoma of the head may appear after a few hours or even months (the so-called lucid interval). The main manifestations of the pathology consist of:

  1. a) cerebral symptoms:
  • headaches;
  • dizziness;
  • nausea, vomiting;
  • general weakness, constant feeling of drowsiness;
  • altered consciousness;
  1. b) Focal symptoms:
  • speech impairment;
  • decreased visual acuity, hearing;
  • lack of movement in the limbs, etc.

Factors of development

The main reason for the appearance of a brain hematoma is a traumatic brain injury of varying severity. Several factors can provoke a rupture of the walls of blood vessels with further hemorrhage and the formation of a hematoma:

  • neoplasms in the brain;
  • arterial hypertension;
  • arteriovenous malformations;
  • vascular aneurysms;
  • diseases of the circulatory system.

Diagnosis and treatment

Intracerebral hematomas can not always be easily and quickly diagnosed, especially if the pathology occurs in a chronic form. This is because there are no specific signs, and headaches, changes in consciousness, neurological disorders are the symptoms inherent in many diseases.

For the diagnosis of hematomas, it is necessary to undergo some medical tests and examinations, in particular CT and MRI. These methods give a complete picture of the condition of hematoma, its location, size and contribute to the determination of pathological processes that have already begun to occur in the body because the neoplasm compresses the soft tissues of the brain.

For the treatment of intracerebral hematoma – operations are considered to be the most effective. Minimally invasive techniques and complete surgical interventions are used to remove the accumulation of blood clots, depending on the size of the hematoma and the risk of possible complications.

Drug treatment of intracerebral hematomas is practically not carried out because of its inefficiency and the risk of the rapid development of cerebral edema. An exception is hematomas of extremely small sizes that do not compress soft tissues. But they require constant monitoring, and at the slightest sign of deterioration, an operation is prescribed.

Methods for removing intracranial hematomas are craniotomy, a minimally invasive technique of applying a keyhole opening. Trepanation is an operation that requires opening the cranium with further removal of blood clots, washing the wound and restoring the integrity of the bones of the skull.

If a person received a serious injury, which led to the crushing of the cranial bones, the deformed area after removal of the hematoma is blocked by a patch from a metal plate or mesh – cranioplasty.

Trepanation is used in emergency cases, when the presence of a hematoma can cause death in a short period, or if the blood clot is very large. After removal of the hematoma, the patient is prescribed medications from the corticosteroid group and diuretics so that brain edema passes faster.