Hematomas in themselves are harmless, but if the bruise is in the head, it can be dangerous. Small hematomas in the head usually go unnoticed and heal on their own. However, larger bruises can put pressure on the brain, causing pain.
There are several types of bleeding in the head:
- Epidural hematoma
- Subdural hematoma
- Subarachnoid hemorrhage
- Intracerebral hematoma
Epidural hematoma
Epidural hematoma (EDH) is a hematoma between the skull bone and the outer meninges. The cause is often head trauma associated with arterial injury. An epidural hematoma is very dangerous; about 15 to 20 percent of all affected persons do not survive such an injury. To relieve pressure on the brain from the bruise, an epidural hematoma over a certain size must be surgically removed.
Subdural hematoma
A subdural hematoma (SDH) is closer to the brain than an epidural hematoma because it is located under the outer meninges. It occurs when there is injury to the so-called bridging veins – in the elderly, such injury is possible even without external force. Larger subdural hematomas must also be surgically removed.
Subarachnoid hemorrhage
If a hematoma occurs between the soft meninges that directly surround the brain and the overlying spider tissue membrane, this is called a subarachnoid hemorrhage. The trigger of such an injury, which is noticeable by severe headaches, neck stiffness as well as nausea and vomiting, is usually a ruptured brain aneurysm.
In such a case, the patient needs immediate surgery. In the case of a subarachnoid hemorrhage, about 50 percent of those affected die within the first month after the hemorrhage; the remaining sufferers often experience coordination problems or a reduction in mental capacity.
Intracerebral hematoma
If a hematoma forms directly in the brain, it is called an intracerebral hematoma. Such an injury results in symptoms such as paralysis, speech and visual disturbances, and nausea and vomiting. Depending on the size of the hemorrhage, there is acute danger to the patient’s life. Even surgery cannot always save the patient’s life in the case of such an injury.
