Hematoma
A hematoma is said when liquid or clotted blood accumulates in the tissues of the human body. It occurs due to rupture of blood vessels. A hematoma accumulates in soft tissues and presses on them and organs that are located nearby. Hematomas can be small and extensive, they can be localized in different places (in tissues, in mucous membranes, in muscles, in brain tissues, in the walls of internal organs, etc.). We used to call small superficial hematomas “bruises” – they, as a rule, do not cause serious health problems and resolve themselves.
Extensive hematomas are dangerous for the formation of seals, scars. The most dangerous are internal hematomas located on muscles, internal organs. But the most dangerous are hematomas located in the intracranial space. They put pressure on the brain, cause damage to it. Such hematomas need to be treated.
The cause of the hematoma is damaged vessels, internal bleeding caused by trauma – shock, bruise, pinching, etc. Sometimes the cause of hematomas are certain diseases (for example, cracks in the esophagus and stomach) that cause bleeding. Risk factors are vascular fragility, deterioration of blood clotting, reduced immunity, senile age, the presence of chronic diseases in the body, metabolic disorders.
TYPES OF HEMATOMAS AND SYMPTOMS
Hematomas are classified by localization, taking into account the relationship to the vessels (there are pulsating and non-pulsating hematomas), by the degree of blood clotting, with or without infection, as well as by clinical signs. According to severity, the degrees of hematomas are divided – light, medium and severe. Severe hematomas are accompanied by severe pain, swelling, swelling, on the extremities they disrupt the functions of the damaged limbs. In the presence of adverse factors, infection of the hematoma and suppuration are possible.
Intracranial hematomas are considered separately. They have their own classification.
Epidural hematomas are located between the skull and the dura mater. Subdural are localized between the dura mater and the arachnoid membrane. Intraventricular are located in the cavities of the ventricles of the brain. Intracerebral hematomas are located in the brain tissues. Subarachnoid hematomas are located in the space between the arachnoid and soft meninges. Symptoms of intracranial hemorrhage are loss of consciousness (fainting), headache, vomiting, psychomotor agitation or lethargy, confusion, drowsiness, paralysis and paresis, hypertension, bradycardia and other symptoms, up to seizures of epilepsy. The pupil’s reaction to bright light decreases. In young children, an increase in the head may be observed. In the absence of treatment, due to compression of the brain and its edema, the patient in most cases falls into a coma. Brain hemorrhages can cause death.
DIAGNOSIS AND TREATMENT
For diagnosis, in addition to examination and questioning of the patient, ultrasound and radiography are used (in the case of intracranial hematomas, an X–ray of the skull in two projections). MRI, CT, echoencephalography and other studies are also used.
Simple hematomas can be treated independently – using cold compresses, dissolving ointments, pressure dressings, a blue or red lamp. Moderate hematomas are treated on an outpatient basis, physiotherapy can be used. The effectiveness of treatment increases the intake of nonsteroidal anti-inflammatory and painkillers.
Treatment of complex hematomas is performed surgically. Intracranial hemorrhages are treated in a neurosurgical hospital.
