What is a hematoma?
A hematoma is not a bruise. It is a pooling of blood outside of the blood vessels deeper in the skin than a bruise occurs. Trauma is the most common cause of a hematoma. Depending on the cause, it can take anywhere from 1 to 4 weeks for a hematoma to go away.
Bruises and hematomas commonly get confused with each other. A bruise happens when capillaries get damaged due to trauma and the blood seeps into the top layer of your skin, causing discoloration. A hematoma happens when blood pools and clots underneath the skin and forms a swollen lump.
Many injuries can develop a hematoma and give the area a firm, lumpy appearance. If you have an injury, you might have more than a bruise. It’s important to see your doctor if your bruise swells or becomes a firm lump, because it might mean something more severe happened under the skin.
Some signs to watch for if you think you might have an inter or intramuscular hematoma are:
- Swelling in the affected area
- Pain in the injured area
A hematoma occurs when there are damaged blood vessels beneath the skin. The blood has nowhere to go, since there is no opening in the skin for it to flow out of, and it begins to build up in the area. This causes tissue swelling and leads to other severe issues if not treated quickly.
This type can occur in two places, subdural or epidural. An epidural hematoma happens when blood pools between the skull and the outer layer of the brain (the dura mater). If the blood is underneath the dura mater, it is referred to as a subdural hematoma.
Diagnosis for hematoma
Your doctor will discuss the nature of any trauma or injuries with you if you can. They’ll want a complete medical history as well, because conditions like hemophilia could cause excessive bruising or blood pooling.
Depending on the type of injury and where it occurred, doctors decide which action to take. Doctors may take x-rays of the area to make sure there are no broken bones and use an ultrasound to measure any hematomas.
Treatments for hematoma
There aren't generally any medications that you can use to treat hematomas unless your doctor decides you need something to help you deal with the pain. They might give you some pain medication, muscle relaxers, or acetaminophen to reduce the swelling.
Sometimes, hematomas can go away on their own. If you have a muscular hematoma, doctors generally recommend the RICE method — rest, ice, compression, and elevation to reduce the swelling and give it time to heal.
Intracranial hematoma treatments are different. These types can also go away on their own. If your doctor decides to let yours heal, they will prescribe rest and periodic observation. However, if your hematoma is serious enough, they may need to drill small holes in your skull to drain the blood. This procedure is called a craniotomy.
If you’ve developed blood clots in the blood vessels in your brain, doctors will want to perform surgery to get rid of them.
Possible complications and side effects
An intracranial hematoma can have severe complications if left untreated. At the same time, there can be complications from letting it heal by itself or performing surgery. There are always risks of infections, bleeding, or further damage to your brain if a doctor performs a surgery to remove blood clots or drain blood from the skull.Epidural hematomas can have some complications if left untreated. These are:
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Cedars-Sinai: “Subdural Hematoma.”
Johns Hopkins Medicine: “Craniotomy.”
StatPearls: “Epidural Hematoma.”
The Journal of the Canadian Chiropractic Association: “Management approaches to acute muscular strain and hematoma in National level soccer players: a report of two cases.”
UCLA Health: “Cerebral Contusion and Intracerebral Hematoma.”
University of North Carolina Wilmington: “INSTRUCTION SHEET: BRUISE/HEMATOMA.”