Hematomas are usually caused by trauma, whether it is the result of a car accident, a minor bump, a cough, or an unknown event. The blood within blood vessels is continually flowing and therefore does not clot or coagulate. When blood leaves the circulatory system and becomes stagnant, there is almost immediate clotting. The greater the amount of bleeding that occurs, the larger the hematoma.
A hematoma is a collection of blood outside of a blood vessel.
• There are several types of hematomas and they are often described based on their location. Examples of hematomas include subdural, spinal, under the finger or toenail bed (subungual), ear, and liver (hepatic).
• Some causes of hematomas are as pelvic bone fractures, fingernail injuries (subungual), bumps, passing blood clots, blood clot in the leg (DVT), blood cancers, and excessive alcohol use.
Types of Hematoma Causing Brain Damage
1. Epidural Hematoma:- Bleeding between the area of skull and dura.
2. Subdural Hematoma:- Bleeding is confined to the area between the dura and arachnoid memberane
3. Intracerebral Hematoma:- Bleeding within the brain itself.
Diagnosis
1 Hematomas of the skin and soft tissues, such as muscle and joints, are often diagnosed by physical examination alone.
2 For patients exhibiting signs of internal bleeding, the health care professional will decide what imaging modality is best to evaluate the situation.
3 Plain X-rays may be needed to assess for bone fracture. Patients with significant head injury often require CT scans.
4 Ultrasound is the testing modality of choice for females who are pregnant.
Symptoms
Hematomas symptoms depend upon their location and whether adjacent structures are affected by the inflammation, redness, tenderness, pain and swelling associated with the bleeding and may include
1 headache,
2 confusion,
3 seizures subdural hematoma,
4 back pain,
5 loss of bladder or bowel control (epidural hematoma),
6 discoloration,
7 nail loss,
8 pain in the nail bed, and
9 abdominal or flank pain (spleen, liver, or peritoneal hematoma).
Treatment
Hematoma treatment depends upon which organ or body tissue is affected.
1 Superficial hematomas of the skin and soft tissue, such as muscle, may be treated with rest, ice, compression, and elevation (RICE). Heat may also be considered.
2 Hematomas of the skin and soft tissues are often treated with rest, ice, compression, elevation (RICE). Some health care practitioners may advocate heat as another treatment alternative. The pain of a hematoma is usually due to the inflammation surrounding the blood and may be treated with over-the-counter pain medications. The choice of medication depends upon the underlying health of the patient. For those patients who are taking anticoagulation medications, ibuprofen is relatively contraindicated (not recommended) because of the risk of gastrointestinal bleeding. Patients with liver disease should not take over-the-counter acetaminophen. When in doubt, it is wise to ask the health care practitioner or pharmacist for a recommendation.
3 Treatment for hematomas involving other organs in the body depends upon what organ system is involved. In these cases, treatment will be tailored to the specific situation.