Intracranial Hematoma

What is Intracranial Hematoma?

The term intracranial hematoma refers to a burst blood vessel or blood vessels inside the skull. This can be in the brain or in the space between the skull and the brain. Hematoma refers to a collection of blood from the burst blood vessel. As the blood from an intracranial hematoma collects and builds up, pressure is put on the brain which can cause serious and severe symptoms.

There are different types of intracranial hematomas that a person can suffer from. An intracerebral hematoma, for example, occurs inside of the brain while an epidural hematoma occurs between the skull and the outer layer of the dura mater that surrounds the brain. There is also a subdural hematoma which can occur between the inner and middle layers of the dura mater.

Most intracranial hematomas occur due to a head injury such as those that occur from a sports injury, a fall, or a vehicular accident. If a person is on blood thinners (anticoagulant drugs) or even a regular aspirin regimen, a mild head injury could cause an intracranial hematoma as well. An intracranial hematoma can occur even if a person has no visible signs of injury outside of their body.

What are the Symptoms of Intracranial Hematoma?

Having a headache after a head injury, especially one that is severe and persistent can be an early symptom of an intracranial hematoma. Vomiting, dizziness or drowsiness, and a loss of consciousness can also be indicative of this serious condition. A person with an intracranial hematoma can also suffer from confusion and slurred or jumbled speech. If the hematoma is large, the affected person could potentially have prolonged loss of consciousness or seizures.

Intracranial Hematoma Causes

Head injuries are the primary cause of intracranial hematoma, although non-traumatic causes also exist, including hemorrhagic stroke, which can rupture an aneurysm. Blood clotting disorders and anticoagulant therapy also increase the risk of intracranial hematoma.

Head injuries are the most frequent causes of intracranial hematoma. A head injury can arise from playing sports, falling from a bicycle or motorcycle, assault, and other activities.

Additional factors increase your risk of intracranial hematoma, including:

  • A family history of intracranial hematoma
  • Alcohol abuse
  • Untreated high blood pressure
  • Liver disease
  • Brain tumor
  • Cigarette smoking
  • Use of drugs that contain amphetamines and MDMA (ecstasy)
  • Use of cocaine
  • Extreme physical exertion
  • Use of anticoagulant or antiplatelet drugs
  • Abnormalities of the blood vessels (aneurysm or vascular malformation)
  • Protein deposits along the blood vessels (amyloid angiopathy)

How is Intracranial Hematoma Treated?

Intracranial hematomas vary in severity and size. Some are minor and will resolve on their own as the blood may be able to drain away naturally. Intracranial hematomas that grow large or begin to cause serious symptoms will require surgery to drain the pooled blood out of the space and relieve pressure from the brain. Sometimes, a small hole can be drilled into the skull (known as a burr hole) to drain blood from an intracranial hematoma. Larger or more extensive hematomas may require a craniotomy where a portion of the skull is removed (and then replaced) to relieve pressure and get all of the blood out.

Intracranial Hematoma Prevention

Preventing a head injury is the most effective way to reduce the risk of an intracranial hematoma.

For example:

  • Wear a seatbelt inside a motor vehicle. High-velocity impacts place you at greater risk of head injury.
  • Protect young children with fitted car seats.
  • Pad countertops and table edges to protect children from hitting their heads.
  • Block stairways so young children cannot fall.
  • Attach heavy furniture and appliances to the wall to prevent them from tipping onto a child.
  • Prevent children from climbing on unsteady objects such dresser drawers.
  • Always wear an appropriate sports helmet.
  • Wear a helmet with a bicycle, motorcycle, skateboard, roller blades, scooters, and so on.
  • Avoid falls, especially as you age.
  • Report suspected child abuse. Shaken baby syndrome can lead to intracranial hematoma and death.

To reduce your susceptibility based on factors other than head injury:

  • Treat high blood pressure.
  • Avoid illegal drugs such as cocaine and ecstasy.
  • Get frequent checkups with your doctor if you take blood thinners.
  • Avoid extreme physical exertion, especially if you are unused to the activity.
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Last Reviewed:
September 21, 2016
Last Updated:
March 09, 2018