Although most hematomas can be treated easily, some may indicate more serious medical problems.
If you have suffered an injury from an accident or suffered a blow to your head, it is important to consult a doctor to determine if there are signs of an inner hematoma.
When Does a Hematoma Need to be Drained
A hematoma is an area where blood collects that is not in the larger blood vessels. Hematomas can be caused by injuries or trauma to the area.
A blood vessel wall can break due to injury, allowing blood to flow into surrounding tissues.
Hematomas can occur in any blood vessel, including veins and arteries. It may be different depending on where it is located.
Although a hematoma can be compared to a haemorrhage, a haemorrhage is continuous bleeding. A hematoma’s blood has usually already clotted.
Types
The location of the hematoma will determine its type. Its location can also determine its potential danger.
- Ear haemorrhage: Aural or ear haemorrhage occurs between the cartilage and skin of the ear. This is common for boxers, wrestlers, and other athletes who frequently sustain head injuries.
- Subungual hematoma: This is a hematoma that appears below the nail. This is common for minor injuries like accidentally hitting your finger with a hammer.
- Scalp hematoma: A bump on the scalp is a sign of a scalp hematoma. It is only a problem with the skin and muscles, not the brain.
- Septal hematoma: Most often caused by a broken nose, a Septal Hematoma can cause nasal problems if the person doesn’t get treatment.
- Subcutaneous hematoma: This hematoma is found just below the skin. It usually occurs in the shallow veins near the surface.
- Retroperitoneal hematoma occurs in the abdominal cavity but not in any other organs.
- Splenic hematoma: This type of hematoma is found in the spleen.
- Hepatic hemostasis: The liver is home to hepatic hemostasis.
- Spinal epidural haemorrhage: This refers to a hematoma between the spinal cord’s linings and the vertebrae.
- Intracranial epidural hematoma: This type occurs between the skull plate and the lining outside the brain.
- A subdural hematoma occurs between the brain tissue and the internal lining.
Causes
Hematomas are most commonly caused by trauma and injuries. Blood leakage can be caused by damage to blood vessels’ walls. This happens when blood pools in the blood vessel and causes a hematoma.
Hematomas do not need to be caused by severe injuries. A simple injury such as a stubbing toe can cause a hematoma.
More serious injuries like vehicle accidents can also cause severe hematomas, falls from heights, and aneurysms.
A hematoma can occur from some surgical procedures, such as cosmetic or dental. They can cause damage to nearby blood vessels and tissues.
Blood thinners can also increase hematomas. Regular users of warfarin, aspirin, and dipyridamole (Persantine), may be at greater risk for bleeding problems, including haemorrhages.
Sometimes, a hematoma may appear without any obvious cause.
Signs
The symptoms of superficial hematomas include:
- Discoloration
- Inflammation and swelling
- Tenderness in the region
- Redness
- Warmth in the skin around the hematoma
- Pain
It may be harder to identify internal hematomas. If you have been in an accident, or suffered a serious injury, it is important to regularly see a doctor to check for hematomas.
A skull hemomatoma can be very dangerous. It is important to be alert for any new symptoms even after a doctor has examined the injury.
- A severe, worsening headache
- Different pupils
- It is difficult to move an arm or leg
- hearing loss
- Trouble swallowing
- Sleepiness
- Drowsiness
- Loss of consciousness
Although symptoms may not appear immediately, they are usually present within the first few days. A 2014 study found that subdural hemorhages usually present within 72 hours after an injury.
Bruise or hematoma?
People mistakenly believe that hematomas or bruises are the same because of the discoloration and tenderness around the area.
When blood leaks from small blood vessels, a bruise forms. This causes a purple, blue or darkened spot on the skin. As it heals, the bruise’s color changes. It will usually lighten or turn yellow before completely disappearing. Bruises are usually not dangerous.
On the other hand, a hematoma is a leakage of a larger blood vessel. It can leave a black or dark blue mark, but it can also cause severe redness. More severe traumas can cause hematomas. These may require medical attention.
Most bruises heal themselves without any treatment. Although severe bruises are rare, they can cause damage to the inner tissues and organs. Treatment is necessary to prevent infection.
Some people are more susceptible to bruising than others, such as those with anemia or vitamin deficiencies or who take blood thinners.
Treatment
Sometimes, a hematoma does not need treatment. The body will usually absorb the blood from the hematoma over time.
A person can manage a hematoma beneath the skin, nail or other soft tissue by resting the area and applying an ice pack wrapped in a towel to reduce swelling.
To prevent the blood vessel from opening again, it may be helpful to wrap the area around the hematoma or splint it. If necessary, a doctor will provide specific instructions.
If the injury is severe, doctors may prescribe pain relief medications. Most doctors will advise patients to stay away from pain relievers such as aspirin. They can thin the blood and make the injury worse.
Sometimes, hematomas may need to be surgically removed. If the blood pressure is too great on the brain, spinal cord or other organs, surgery may be necessary. Doctors in other situations may remove a hematoma at risk of infection.
Even if the hematoma is within the skull, surgery may not be required in all cases. In a 2015 study, authors found that most people with subdural haemorrhages received conservative treatment. Only 6.5% of these patients required surgery at a later stage.
Rarely the hematoma can continue to grow as the blood vessel that has been damaged continues to release more blood. Doctors will have to remove all the old and new blood from the hematoma.
Complications
Sometimes complications can arise from a hematoma that is not treated.
A brain hematoma may be hard to detect if the person doesn’t have specific tests. You may feel a persistent headache, dizziness, and slurred speech.
Anybody who has sustained a head injury or severe injuries elsewhere in their body should consult a doctor.
When should you see a doctor?
Many hematomas can be treated with simple procedures. Although a hematoma beneath the nail or skin can be painful, it is not likely to cause any complications.
It is best to get medical attention if a hematoma feels particularly painful. The doctor will be able to give you advice on how to brace or wrap the area. If the area is discolored, swelling, or feels warm.
Anybody who has suffered a head injury must see a doctor report any symptoms. If they suspect a hematoma in the skull, a doctor might order imaging scans.
Anyone who has been in a serious accident such as a car accident or falls from a height should also regularly visit their doctor. Doctors may recommend that you have hematoma or bruising checked after the initial swelling has subsided.
Summary
Although hematomas may look scary, proper treatment can ensure that they don’t cause lasting damage.
Minor hematomas can be managed at home by using conservative treatments.
A doctor should be consulted if you have suffered a head injury, an accident, or your hematoma showing signs of infection. Most hematomas can be treated quickly and without complications with the right treatment.
