A hematoma on the head

A hematoma on the head is a hemorrhage that occurs after a blow or sharp pressure from a hard object or surface. With this injury, blood accumulates in the tissues without spilling out.

[ 1 ], [ 2 ], [ 3 ], [ 4 ]

Causes of hematoma in the head

Interstitial hemorrhage (hematoma) occurs when blood vessels deep in the tissues are damaged. The cause may be direct head trauma of various types (during road accidents, falls, head blows, etc.). External manifestations of hematoma (visible wound surface, external bleeding) are not necessary in such situations; hemorrhage in deep tissue layers may not reveal itself in any way, or may only manifest itself as a slight swelling.

Patients who are most at risk of developing hematomas are those who constantly take medications that reduce blood clotting (heparin, neodicumarin, etc.) or inhibit platelet aggregation (acetylsalicylic acid, sodium citrate, etc.). Also at risk are the elderly and those who abuse alcohol and smoking due to their inherent increased vascular fragility.

Unfortunately, trauma is not the only factor in the occurrence of hematoma. The causes may also be blood diseases ( hemophilia, leukemia), autoimmune diseases, malignant tissue neoplasms.

The occurrence of hematoma in newborns is caused by the load, compression of the baby's head when passing through the birth canal. In premature babies, hematoma on the head can occur due to weak, insufficiently developed tissues of the child's body.

[ 5 ], [ 6 ]

Hematoma on the head after a fall

External manifestations of a hematoma after a fall do not always correspond to the level of damage. Internal hemorrhages in the tissue may not be visible.

In case of significant trauma with pronounced symptoms of impaired brain function, you should immediately call an ambulance.

As for relatively light blows to the head, especially in childhood, it is much more difficult to diagnose the pathology in time. Children fall a lot and often, and there is no need to panic at the slightest fall, although it is necessary to take a closer look at the child. A small hematoma on the head usually goes away in a week, especially if in the first minutes after the blow you apply a cold compress or ice to the damaged area, having previously wrapped it in a towel.

The most important thing is to determine whether the fall has caused internal bleeding. The most typical signs of this condition are:

• confusion or loss of consciousness;
• speech disorders;
• strange behavior;
• strong excitement, or, conversely, drowsiness;
• persistent headache;
• convulsive state;
• nausea;
• movement coordination disorder;
• weakness in the limbs;
• different pupil sizes.

If you experience at least one of these symptoms, you should immediately consult a doctor.

[ 7 ], [ 8 ], [ 9 ]

Hematoma of the head after a bruise

A bruise is a result of a blunt blow to the head, usually causing a closed hematoma without visible damage to the skin.

Severe bruises can be characterized by a sharp loss of consciousness, nausea, which indicates damage to brain tissue. In such a state, it is imperative to call an ambulance and provide the patient with maximum rest, applying cold to the site of the bruise.

The consequences of a head hematoma after a bruise can be different, and this depends on many circumstances. Some bruises are minor, and recovery occurs within a few days. But there are injuries, at first glance, not severe, which cause the appearance of internal hematomas, which can lead to quite serious consequences. Hemorrhage can occur in the brain or near its membranes: a semi-liquid accumulation of blood puts pressure on the brain tissue and provokes its deformation. As a result, some functions controlled by the brain are disrupted: breathing, coordination, etc. The earlier the brain damage is diagnosed, the more favorable the prognosis.

[ 10 ], [ 11 ], [ 12 ]

Birth hematoma on the head

A birth hematoma on the head usually disappears without any consequences for the child. Such an injury occurs quite often and does not pose any danger. This is a visible swelling at the site of tissue compression during the passage of the birth canal, which occurs due to hemostasis and lymphostasis. The swelling soon disappears, and the hematoma is absorbed.

Of course, there are unpleasant exceptions to the rule: birth hematomas can increase in children with reduced blood clotting. This condition can be caused by a hereditary factor, a lack of vitamins K and P, and some microelements responsible for the permeability of the vascular wall.

In such situations, treatment is required: administration of blood clotting drugs, vitamin complexes.

In severe cases, a purulent infection may join the hematoma. To prevent this, the best prevention is breastfeeding: the immunostimulants and vitamins contained in mother's milk will help the baby's body cope with unnecessary bacteria.

[ 13 ]

Symptoms of a hematoma in the head

According to the location of hematomas, three main types can be identified:

• subcutaneous location - this is the occurrence of hemorrhage in the subcutaneous space without damage to the skin structure;
• intramuscular location - this is a hematoma in the intramuscular space; subcutaneous and intramuscular hematomas are very similar in symptoms (painful, swollen skin, possibly with a bluish tint), and are usually not dangerous for patients;
• Intracephalic hematomas, in turn, are subdivided into epidural (hematoma in the subcranial region) and subdural (hematoma of the meninges).

Hematomas on the head have a number of characteristics: pain at the site of occurrence, swelling, change in skin color to bluish, then to greenish-purple. Local temperature change is allowed.

Intracranial hematomas are accompanied by signs of excessive pressure on tissues and impaired brain function (headache, loss of consciousness, nausea, drowsiness, and in severe cases, a comatose state may develop). During the examination, abnormal intracranial pressure, bradycardia, increased blood pressure (or asymmetry), non-inflammatory edema of the optic nerve, different pupil sizes, and manifestations of epilepsy are also detected.

[ 14 ]

Hematoma on the head of a child

Unfortunately, a hematoma on a child's head is quite a common occurrence; the baby may fall from a crib, chair, or steps. As a result of the impact, the affected area is subject to changes in the skin and sharp pain when pressed.

The peculiarities of the children's skeletal system are its weakness and vulnerability, therefore the risk factor for hematoma in children is more pronounced than in adults. Hematomas in children under 3 years of age are the most severe.

Symptoms of internal hematoma of the head appear immediately after the injury. This is a disturbance of consciousness, agitation, or, conversely, apathy in a child, nausea, headache. With any of these manifestations, you should definitely consult a doctor.

Small and shallow hematomas do not require hospitalization: the child is given a tight bandage, a cold compress, and possibly painkillers. Large hematomas are punctured to remove the contents and an occlusive dressing is applied; injuries complicated by suppuration and infection are opened and drainage is installed.

Any hematoma on a child's head should not leave parents indifferent. To prevent serious consequences, a comprehensive diagnosis should be carried out and the necessary timely treatment should be prescribed.

[ 15 ], [ 16 ], [ 17 ], [ 18 ], [ 19 ]

Hematoma on the head of a newborn

A hematoma on the head of a newborn occurs as a result of a difficult labor period, a long stay of the head in the pelvic area and excessive pressure on it. This often occurs during protracted labor, multiple pregnancies, a large fetus or a narrow pelvis in the mother. The difference between external and intrauterine pressure also plays a role, which leads to damage to the capillaries and small vessels. A hematoma can appear in any area of the head, on the face of the newborn.

Premature babies are more susceptible to the risk of developing hematomas than others; their tissues and vessels are so delicate that they react extremely easily to even slight compression.

The most common type of hematoma in a newborn child is cephalohematoma, characterized by the appearance of swelling in some area of the head. This swelling is nothing more than a small hemorrhage between the bone tissue of the skull and the periosteum. Moreover, the skin in this case may not change. Such hematomas can occur in 2% of newborns.

[ 20 ], [ 21 ], [ 22 ], [ 23 ], [ 24 ]

Consequences of head hematoma in newborns

The presence of a hematoma on the head of a newborn baby is very unpleasant, but not always dangerous. The injury must be closely monitored; under favorable circumstances, it will pass without consequences within two weeks or up to a month, depending on the size of the hematoma. If there is no visible improvement, it is imperative to show the child to a doctor, who, after conducting an examination and the necessary tests, will assess the situation and prescribe treatment. It may be necessary to aspirate the hematoma. This is a simple procedure, but thanks to it, the baby will immediately feel relief. If the blood is not removed, unpleasant consequences may occur in the form of suppuration of the hematoma, ossification of its individual areas, which will eventually manifest itself as deformation of the head.

The ideal course of a newborn hematoma is independent slow absorption without medical intervention. After the first week, it gradually decreases, and after three to five weeks there is no trace of it left. If the hemorrhage is large enough, a little more time may pass until complete recovery. The main sign that the process is normalizing is a slow but stable decrease in the size and severity of the formation.

If you have any doubts or suspicions about the static nature of the process, it is recommended that you visit a specialist.

Subcutaneous hematoma on the head

A subcutaneous hematoma on the head is formed when blood penetrates into nearby tissues through damaged vascular walls. As a rule, this is a hemorrhage without breaking the integrity of the skin. It appears as a result of a fall and a head injury, especially when taking anticoagulants, or in people suffering from disorders of the blood coagulation system.

The subcutaneous hematoma initially has a bluish tint, which changes to yellow-green within a few days.

The size of the subcutaneous hemorrhage can be much larger than it seems externally. This can lead to some unpleasant consequences: excessive pressure on the tissue, development of a local inflammatory process, suppuration.

If a subcutaneous hematoma does not resolve over a long period of time, pain appears when pressing, or a headache occurs, it makes sense to consult a traumatologist.

A subcutaneous hematoma in a child also requires constant monitoring of the general condition: small children are not always able to say what is bothering them, so the observation of parents and a certain approach to the child will help to avoid unnecessary consequences.

[ 25 ], [ 26 ], [ 27 ]

Soft tissue hematoma of the head

In addition to hemorrhage, soft tissue hematoma is characterized by the destruction of subcutaneous tissue, muscle tissue elements and blood vessels.

Small hematomas occur as a result of minor mechanical impact that does not disrupt the overall functionality of the body, and are manifested only by cyanosis of the skin and pain when pressed.

Moderate hematomas may not appear until several hours after the impact. Swelling and pain appear at the site of the lesion. Moderate hemorrhage may not require special treatment other than applying a tight compression bandage to the site of the lesion.

With a significant hematoma of soft tissues, the symptoms increase within an hour and a half. Hemorrhage into the tissues can be prolonged, which will require a doctor's examination and the appointment of some additional types of diagnostics (for example, X-ray examination or computed tomography) to choose the correct treatment tactics.

[ 28 ]

Treatment of hematoma on the head

Treatment measures aimed at eliminating traces of hemorrhage are selected depending on the size and nature of the hematoma. If the hematoma is superficial, you can limit yourself to regular home treatment: apply cold or ice to the site of injury, apply a tight compression bandage. These methods will allow you to block the bleeding vessels and stop the hemorrhage. After a couple of days, warm compresses are recommended to speed up the resorption of the blood clot. Physical therapy, the use of heparin ointment, bodyaga, creams with medicinal leech extracts are also recommended for this purpose.

If there is a significant accumulation of blood between the tissues, a skin puncture and aspiration of the accumulated fluid is performed. This procedure is performed in a hospital setting.

If blood continues to accumulate in the tissues, the hematoma is opened and the damaged vessels are bandaged.

Treatment of hematoma on the head with conservative methods includes the prescription of analgesics, sometimes bactericidal and anti-inflammatory drugs, as well as vitamin therapy.

Epidural hematoma requires surgical treatment.

[ 29 ], [ 30 ], [ 31 ], [ 32 ]

Removal of hematoma in the head

The choice of surgical intervention options for internal hematomas depends on the location of the formation and the severity of the injury. Therefore, a qualified neurosurgical examination is first carried out, including computed tomography and magnetic resonance imaging, and vascular examination.

Shallow intramuscular hematomas are removed by opening the formation, ligating the bleeding vessels and applying stitches. Such uncomplicated hemorrhages have a favorable prognosis.

Intracranial hematoma is removed using the method of resection and osteoplastic trepanation of the skull, in which blood clots are removed through a burr hole.

The hematoma must be completely removed. Incomplete removal can cause serious consequences, even death.

Treatment of hematoma in newborns is carried out using laser exposure or surgery. In both cases, the doctor stops the bleeding by blocking the bleeding vessels and removes the hematoma completely.

Take care of yourself and your children, in emergency situations do not be afraid to contact a doctor. Any head injury should not be left without attention, be it a bruise, a wound or a hematoma on the head.

[ 33 ], [ 34 ]