Headache is one of the most common symptoms in the adult population. Less commonly, it develops in children. Headache can be associated with various diseases, as well as changes in weather conditions, atmospheric pressure, stress, etc. The cause of this symptom is any intoxication (inflammatory pathologies, poisoning, infections), neurological disorders, injuries, migraines. People often do not pay attention to a headache, getting used to it and considering it not dangerous. This is not true. In some situations, this symptom is very serious. It may indicate, for example, a pathology such as intracranial hematoma. Often its appearance is associated with a head injury. But there are other reasons for its development.
What is intracranial hematoma ?
Symptoms arising from intracranial hematoma develop due to compression of the brain with blood. Lack of treatment can lead to serious damage to the central nervous system. The danger of the disease is that signs of pathology occur gradually.
So what is a hematoma inside the skull? For various reasons, hemorrhage from the vessels of the head may occur. As a result, a so-called bruise forms in the meninges - a hematoma. Unlike hemorrhages in soft tissues and skin, it resolves very slowly. Only small hematomas can disappear on their own. With medium and large sizes of hemorrhage, surgical intervention is necessary.
Causes of hematoma
You need to know that hematomas in the membranes or substance of the brain arise from various diseases and injuries. In most cases, severe shock to hard surfaces (floor, walls, ice), car accidents lead to hemorrhage. In old age, the risk of developing intracranial traumatic hematomas increases significantly. This is due to the weakness of the walls of blood vessels located in the brain and its membranes.
But in some cases, intracranial hematoma is formed in the absence of traumatic effects. This is due to rupture of the blood vessel aneurysm. Such a disease can be either congenital (malformation) or acquired. Aneurysm is formed as a result of the lack of treatment for arterial hypertension.
Another cause of intracranial hematoma is a tumor of the brain or its membranes. Both benign neoplasms and oncological processes lead to hemorrhage.
The development of a hematoma is also facilitated by atherosclerotic lesions of the cerebral vessels, infectious pathologies, history of stroke or transient ischemic attack, angioedema. The risk of developing hemorrhage is increased in the elderly, smokers, people suffering from arterial hypertension and obesity.
Varieties of intracranial hematomas
Depending on the size, small, medium and large hematomas are distinguished. Also, intracranial hemorrhages are classified according to the course and localization.
The volume of small hematomas is less than 50 ml. In some cases, they resolve on their own. If the volume of hemorrhage is from 50 to 100 ml, then it is called the average hematoma. They require surgical treatment. Hematoma, the volume of which reaches more than 150 ml, can lead to death.
According to the clinical course, 3 types of hemorrhages are distinguished. Signs of acute intracranial hematoma are detected within 3 days from the moment of its formation. They are considered the most dangerous. Subacute hematomas are detected within 3 weeks. The deterioration of the condition occurs gradually. Chronic hemorrhages make themselves felt after 3 weeks from the moment of their formation.
By localization, the following types of pathologies are distinguished:
- Epidural intracranial hematoma. It is formed when the artery located between the outer surface of the dura mater and the skull is damaged.
- Subdural hematoma. The source of bleeding is the veins that connect the substance of the brain to the sinuses of the hard membrane. Most often, it has a subacute course.
- Intracerebral hematoma. Such a hemorrhage is very dangerous. It develops as a result of the impregnation of brain matter. Such hemorrhage can cause irreversible damage to nerve cells.
- Intracranial hematoma of the brain stem. This type of hemorrhage is fatal.
- Diapedetic hematomas. Develop due to increased vascular permeability of the brain.
Depending on the location and source of hemorrhage, the clinical picture of hematomas may be different. Based on this, treatment tactics are selected.
The clinical picture of pathology
How to determine that an intracranial hematoma has formed? Symptoms of pathology depend on the type of hemorrhage. So, symptoms of epidural hematoma include severe headache, convulsive syndrome, impaired consciousness and drowsiness. When studying the reaction of pupils to light, anisocoria is noted. Later paralysis of the extremities join. Signs of intracranial hematoma are detected within a few hours or days of damage to the artery. In children, symptoms develop faster.
Subdural hematoma is characterized by the following clinical picture:
- headache predominates;
- nausea and vomiting that does not bring relief;
- meningeal signs;
- convulsive seizures are sometimes noted.
Symptoms of intracerebral hemorrhage are similar. Unlike signs of a subdural hematoma, pain covers one side of the head, loss of consciousness is noted. Intracerebral hemorrhage often leads to paralysis of the limbs.
Diapedetic hematomas are characterized by persistent headaches. It is most difficult to identify them, since they are small in size.
Diagnosis of hematoma inside the skull
Intracranial traumatic hematomas are diagnosed first of all, since in most cases people seek medical help after receiving injuries. It is more difficult to detect hemorrhages that arose against the background of vascular diseases. Diagnostic methods include:
- Computed tomography of the brain.
- X-ray examination of the skull.
- Magnetic resonance imaging.
For differential diagnosis of headaches , an ultrasound of the vessels is performed with dopplerography, EEG, echoencephalography.
Methods for treating the disease
Treatment of intracranial hematomas is carried out by conservative and surgical methods. In the absence of complications and small hemorrhages, the doctor only observes the patient's condition. In this case, the patient must be in a hospital and observe bed rest. If the hematoma does not resolve on its own, prescribe drugs that reduce intracranial pressure. Symptomatic therapy is also performed. Prescribe drugs "Relanium", "Furosemide", "Ketonal."
Surgery
In most cases, surgical removal of intracranial hematoma is indicated. It consists in the evacuation of blood. To this end, the following types of surgical procedures are performed:
- Osteoplastic trepanation. It is characterized by the production of a small hole in the skull and the removal of blood clots with special tools and a vacuum device.
- Stereotactic intervention. Blood from the cranial cavity is removed using a special cannula.
- Puncture and aspiration removal of hematoma. It consists in staging a thin catheter.
The method of surgical treatment is selected by a neurosurgeon, depending on the size of the hemorrhage, associated pathologies and the patient's age.
Intracranial hematoma: consequences of the disease
The effects of a hematoma include clinical manifestations such as post-traumatic cramps, amnesia, headache, and general weakness. These symptoms can occur for several months. Therefore, rehabilitation takes about six months. If surgical treatment is not done on time, a hematoma can lead to the development of paralysis, cerebral edema, and death.