Headache is one of the most common symptoms among adults. It rarely develops in children. Headache can be associated with various diseases, as well as with changes in weather conditions, atmospheric pressure, stress, etc. The cause of this symptom is any intoxication (inflammatory pathologies, poisoning, infections), neurological disorders, injuries, migraine. People often do not pay attention to the 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 that occur with intracranial hematoma develop as a result of compression of the brain by blood. Left untreated, serious damage to the central nervous system can result. The danger of the disease lies in the fact that the signspathologies occur gradually.
So, what is a hematoma inside the skull? Due to various reasons, hemorrhage from the vessels of the head can occur. As a result, a so-called bruise in the meninges is formed - a hematoma. Unlike hemorrhages in soft tissues and skin, it resolves very slowly. Only small hematomas can disappear on their own. For medium and large hemorrhages, surgical intervention is necessary.
Causes of hematoma
You need to know that hematomas in the membranes or substance of the brain occur as a result of various diseases and injuries. In most cases, strong blows on hard surfaces (floor, walls, ice), car accidents lead to the development of 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 even in the absence of traumatic impact. This is due to the rupture of an aneurysm of the blood vessels. Such a disease can be either congenital (malformation) or acquired. An aneurysm is formed as a result of untreated 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 promoted by atherosclerotic lesions of cerebral vessels, infectious pathologies, stroke or transient ischemic attack, angioedema disorders. The risk of hemorrhage is increased in the elderly, smokers, those 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.
Small hematoma volume 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 an average hematoma. They require surgical treatment. A hematoma larger than 150 ml can be fatal.
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.
The following types of pathologies are distinguished by localization:
- Epidural intracranial hematoma. It is formed when an 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 brainbrain with dural sinuses. Most often it has a subacute course.
- Intracerebral hematoma. Such a hemorrhage is very dangerous. It develops as a result of impregnation of the substance of the brain. This hemorrhage can cause permanent damage to nerve cells.
- Intracranial hematoma of the brain stem. This type of hemorrhage is fatal.
- Diapedetic hematomas. Develop due to increased permeability of brain vessels.
Depending on the location and source of hemorrhage, the clinical picture of hematomas may be different. Based on this, treatment tactics are selected.
Clinical picture of pathology
How to determine that an intracranial hematoma has formed? Symptoms of pathology depend on the type of hemorrhage. So, the signs of an epidural hematoma include severe headache, convulsive syndrome, impaired consciousness and drowsiness. In the study of the reaction of pupils to light, anisocoria is noted. Later, paralysis of the limbs joins. Signs of intracranial hematoma are detected within a few hours or days from the moment of damage to the artery. In children, symptoms develop more quickly.
Subdural hematoma is characterized by the following clinical picture:
- headache prevails;
- nausea and vomiting with no relief;
- meningeal signs;
- sometimes seizures occur.
Symptoms of intracerebral hemorrhage are similar. Unlike symptomssubdural hematoma, pain covers one side of the head, loss of consciousness is noted. Intracerebral hemorrhage often leads to limb paralysis.
Diapedetic hematomas are characterized by persistent headaches. They are the most difficult to identify, as they are small.
Diagnosis of a hematoma inside the skull
Intracranial traumatic hematomas are the earliest to be diagnosed, as in most cases people seek medical help after injury. It is more difficult to detect hemorrhages that have arisen against the background of vascular diseases. Diagnostic methods include:
- Computed tomography of the brain.
- X-ray examination of the skull.
- Magnetic resonance imaging.
To conduct a differential diagnosis of headaches, ultrasound of the vessels with Dopplerography, EEG, echoencephalography is performed.
Methods of treating the disease
Treatment of intracranial hematomas is carried out by conservative and operative methods. In the absence of complications and the small size of the hemorrhage, the doctor only monitors the patient's condition. In this case, the patient must be in the hospital and observe bed rest. If the hematoma does not resolve on its own, prescribe drugs that reduce intracranial pressure. Symptomatic therapy is also carried out. Prescribe drugs "Relanium", "Furosemide", "Ketonal".
Conduct operationalinterventions
In most cases, surgical removal of an intracranial hematoma is indicated. It consists in the evacuation of blood. For this purpose, the following types of surgical interventions are performed:
- Osteoplastic trepanation. It is characterized by making a small hole in the skull and removing blood clots with special instruments and a vacuum device.
- Stereotactic interference. Blood is removed from the cranial cavity using a special cannula.
- Puncture-aspiration removal of a hematoma. It consists in setting a thin catheter.
The neurosurgeon selects the method of surgical treatment, depending on the size of the hemorrhage, comorbidities and the age of the patient.
Intracranial hematoma: consequences of the disease
The consequences of a hematoma include such clinical manifestations as post-traumatic convulsions, amnesia, headache and general weakness. These symptoms may last for several months. Therefore, rehabilitation takes about six months. If surgical treatment is not carried out in time, a hematoma can lead to the development of paralysis, cerebral edema and death.
