Intracerebral hematoma (Intraparenchymal hematoma of the brain)

Subdural hematoma is a pathological condition characterized by a limited accumulation of blood between the dura and arachnoid membranes of the brain. It accounts for up to 40% of all intracranial hematomas. Most often it occurs as a result of traumatic brain injuries in male patients over the age of forty.

The danger of a subdural hematoma is that it negatively affects the brain structures located around it through pressure on them, their displacement and even damage. So she gives them some serious time. The reasons for its appearance are hemorrhages and traumatic injuries to the blood vessels of the brain.

The Neurosurgery Department of CELT invites you to undergo diagnostics and treatment of hematomas in Moscow. Our multidisciplinary clinic is equipped with the latest technology and has high-precision diagnostic equipment that allows you to make a correct diagnosis. Our specialists use gentle techniques to provide treatment in accordance with international standards.

Etiology of subdural hematomas

This type of hematoma is most often a consequence of traumatic brain injuries and ruptures of blood veins that develop as a result of them, passing in the subdural space. However, the reasons do not necessarily lie in injuries; sometimes hematomas can be provoked by pathological conditions characterized by the destruction of the walls of blood vessels and a decrease in their plasticity. Other reasons are as follows:

• Blood diseases that change its properties;
• Diseases of the blood vessels of the brain;
• Increased intravascular and blood pressure;

A hematoma formed on the side of the injury appears with a small contact area and even without direct contact. This can happen when stopping too suddenly or changing the direction of movement, as well as when falling on the lower limbs or legs. In the process, a sharp shaking of the head occurs, provoking a displacement of the cerebral hemispheres inside the skull, leading to rupture of the blood veins.

As for a hematoma formed on the opposite side of the injury, it can form when the head hits a large, inactive object, causing a large contact area. Much less often, hematomas are formed due to injuries directly to the veins and arteries when the integrity of the dura cerebral membrane is violated.

First aid for concussion

1. If one or more symptoms are present, immediately call an ambulance or take the victim to a doctor.
2. Treat a wound on the head if it appears as a result of an impact.
3. For an hour or until the doctor arrives, it is important not to fall asleep, but to remain at rest.
4. If you lose consciousness, lay the person on his side, bend his knees, and put his hands under his head.
5. If symptoms of a concussion do not immediately appear, it is recommended to rest and not begin vigorous activity.

Clinic of subdural hematomas

Clinical manifestations of subdural hematomas are presented in two large groups, which can be found in our table below:

Intracerebral hematoma (Intraparenchymal hematoma of the brain)

General cerebral symptoms

In most cases, intraparenchymal hematoma is accompanied by severe cerebral symptoms. Patients experience dizziness, intense headache, nausea and vomiting. More than half of cases of intracerebral hematoma are characterized by impaired consciousness from stupor to coma. Sometimes depression of consciousness is preceded by a period of psychomotor agitation. The formation of an intracerebral hematoma can occur with the presence of an erased light gap in the patient’s condition, with a longer light gap or without it.

Focal symptoms

The focal symptoms of intracerebral hematoma depend on its volume and location. Thus, with small hematomas in the area of ​​the internal capsule, a more pronounced neurological deficit occurs than with significantly larger hematomas localized in areas of the brain that are less functionally significant. Most often, intracerebral hematoma is accompanied by hemiparesis, aphasia (speech disorder), sensory disturbances, asymmetrical tendon reflexes of the right and left extremities, and convulsive epileptic seizures. Anisocoria, hemianopsia, frontal symptoms may be observed: a disorder of criticism and memory, behavioral disorders.

Dislocation syndrome

An extensive intracerebral hematoma quickly leads to the appearance of dislocation syndrome, which occurs as a result of displacement of brain structures. Causing an increase in the volume of the contents of the cranium, an intracerebral hematoma leads to a displacement of brain structures in the caudal direction and herniation of the cerebellar tonsils into the foramen magnum. The consequence of this is compression of the medulla oblongata, clinically manifested by stem symptoms: nystagmus, impaired swallowing (dysphagia), respiratory rhythm disorder, diplopia, hearing loss, vestibular ataxia, hypo- or anosmia, strabismus and drooping of the upper eyelid, bradycardia, hyperthermia and increased blood pressure.

Hemorrhage into the ventricles

Intracerebral hematoma with a breakthrough of blood into the ventricles is characterized by hyperthermia, rapidly developing depression of consciousness up to coma, the presence of meningeal symptoms, hormetonic convulsions - a paroxysmal increase in the tone of the muscles of the limbs, as a result of which the arms are bent and brought to the body, and the legs are extended as much as possible.

A delayed intracerebral hematoma is clinically manifested by a lack of improvement in the patient’s condition or a sharp deterioration in his condition a day or more after the injury.

Diagnosis of subdural hematomas

Recognition of a subdural hematoma can be seriously complicated by the variety of its clinical manifestations. In order to correctly make a diagnosis, the neurologist takes into account the following factors:

• Nature and characteristics of traumatic injury;
• Development of disturbances of consciousness;
• Presence/absence of a light gap;
• Neurological status of the patient.

Instrumental diagnostic studies that are prescribed to the patient are presented as follows:

• X-ray of the skull;
• Detailed examination of the fundus (ophthalmoscopy);
• Cerebral angiography (study of cerebral vessels);
• Computer and magnetic resonance imaging, incl. and with contrast.

Causes of pathology

The brain is located inside the skull, it is enclosed in soft membranes and washed with blood and brain fluid. They occupy a volume of 1.5–2 liters. These fluids are incompressible, so if blood begins to pour into the cranial cavity during a rupture of a vessel or an impact, a displacement of the brain occurs - dislocation.

Of the total number of head injuries, hematomas make up no more than 10%. However, they are the ones that account for the highest mortality rate. The most serious cases during hospitalization occur in unconscious victims.

In addition to traumatic etiology, hemorrhage can be vascular or iatrogenic in nature, occurring due to hemophilia, craniocerebral disproportions, sepsis, brain tumors, intoxication, etc.

Treatment of subdural hematomas

The treatment tactics for subdural hematomas are based on the results of diagnostic studies and the individual indications of the patient. It may involve the use of conservative or surgical techniques.

The Department of Neurology at CELT sees neurologists and neurosurgeons with many years of experience in scientific and practical work. You can make an appointment with them online on our website or by contacting our operators: +7 (495) 788 33 88.

Make an appointment through the application or by calling +7 +7 We work every day:

• Monday—Friday: 8.00—20.00
• Saturday: 8.00–18.00
• Sunday is a day off

The nearest metro and MCC stations to the clinic:

• Highway of Enthusiasts or Perovo
• Partisan
• Enthusiast Highway

Driving directions

Recommendations for the treatment of concussions

If hospitalization is not required, with the permission of a doctor, a mild concussion can be treated at home:

1. Bed rest and rest are required, no work. Long sleep is very important.
2. You cannot read, watch TV, play computer games or use gadgets.
3. Under no circumstances should you play sports.
4. You are allowed to listen to music, but not through headphones.
5. You can use herbal sedative drops or herbal infusions.
6. In your diet, you should give preference to dairy and plant products, limit salt intake - to prevent increased pressure, including intracranial pressure.

If the patient seeks medical help in a timely manner and all recommendations are followed, recovery will occur quickly and without complications.

Transmedavia – emergency medical assistance that saves lives

A brain hematoma is a serious injury, inattention to which can lead to the development of serious or even irreversible consequences. Timely, competent medical care can reduce the likelihood of developing complications and avoid death, and therefore, in severe cases, the count is not in hours, but in minutes.

Our doctors are true professionals in their field, who have modern, comfortable cars at their disposal, equipped with everything necessary to provide emergency care to victims. By using, you can be sure that the ambulance team will arrive quickly, take the necessary measures to save the patient’s life and deliver him to the appropriate medical facility as soon as possible. If necessary, we are also ready to arrange transportation for you to another region or treatment abroad.

Hematomas in a newborn

A hematoma on a child’s head often occurs during childbirth. There are two main causes of bruising in a newborn.

Causes:

• Compression of the baby's head when passing through the birth canal.
• Sudden change in blood pressure at birth.

There are factors that increase the risk of such a pathology.

Factors:

• Prematurity,
• Discrepancy between the size of the child’s head and the lumen of the mother’s birth canal,
• Using forceps or a vacuum during childbirth
• The newborn is quite large,
• Use of caesarean section.

A hematoma on the head of a newborn after birth should go away on its own in about two weeks. The larger the damage, the longer it will take to heal.

The gradual disappearance of the bruise and good health indicate a normal healing process.

In certain cases, aspiration may be used. It is carried out in cases of no improvement. To remove a hematoma, two needles are used - one is used to pump out the blood, the other is used to normalize the pressure. The operation is carried out quickly, and relief in children occurs after a short period of time.

A bruise on a baby’s head is not considered dangerous, but requires observation and care. If parents notice that the child is nervous, capricious, eats and sleeps poorly, then they should contact a pediatrician.