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Hematoma

A hematoma is the accumulation, or “pooling,” of blood outside an artery, vein, or capillary. It can occur under the surface of the skin or deep within the body. Hematomas are named for the location in which they occur. Below is a list of different hematomas and where they can be found:

This type of hematoma occurs in the space between the brain and the dura mater (a lining that surrounds the brain)

This type of hematoma occurs in the space between the brain and the skull

This type of hematoma occurs in the space between the spinal cord and the vertebrae

This type of hematoma occurs in the space between the nail bed and nail

This type of hematoma occurs inside the abdomen

This type of hematoma occurs underneath the skin of the ear

This type of hematoma occurs within the spleen

This type of hematoma occurs within the liver

Symptoms

The following symptoms are observed at the site of a hematoma:

  • Bruising and skin discoloration
  • Redness and swelling due to inflammation
  • Pain and tenderness

Additional symptoms of a hematoma vary depending on its location. For example, a subdural hematoma occurs between the brain and dura mater. The symptoms include headache and confusion. Meanwhile, an epidural hematoma occurs between the spinal cord and vertebrae. The symptoms include loss of bladder or bowel control.

Causes

Hematomas typically occur from trauma. Trauma can come from car wrecks, sports, falls, or physical abuse. Other causes for hematomas include the following:

  • Aneurysm
  • Bone fracture
  • Medical procedure (i.e., surgery or biopsy)

Risk Factors

Factors that increase one’s chances of developing a hematoma include:

  • Older age

Elderly individuals are more likely to develop hematomas. One reason is because they are more at risk for falls and traumatic injuries. In addition, the skin becomes thinner and less protective as one ages. This makes it more likely that underlying blood vessels will rupture under impact.

  • Medications

Several medications, such as blood thinners (also known as anticoagulants), aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs), are known to impact the blood’s ability to clot. The more blood that escapes a damaged blood vessel before it clots, the more likely a hematoma will form.

  • Alcohol abuse

Alcohol is a vasodilator, which causes blood vessels to expand. This causes the blood vessels to bleed more when injured.

  • Blood disorders

Blood disorders, such as haemophilia and Von Willebrand disease, are characterized by a decrease or absence in clotting factors. A person with a bleeding disorder develops hematomas much easier and with less injury than a person without a bleeding disorder.

  • Viral infections

Certain viral infections, such as HIV and hepatitis C, can affect the blood’s ability to clot. As stated above, the more blood that escapes a damaged blood vessel before it clots, the more likely a hematoma will form.

Diagnosis

Depending on the location of the hematoma, a doctor can reach a diagnosis either through a physical exam or from imaging. Imaging techniques include a computerized tomography (CT) scan or magnetic resonance imaging (MRI).

Treatment

Minor hematomas generally resolve on their own with minimal treatment. Doctors may recommend the RICE method. RICE is an acronym that stands for rest, ice, compression, and elevation. Pain is treated with common pain relievers such as Tylenol or Advil. For more serious hematomas, surgery may be performed to remove the blood and alleviate symptoms.

Prevention

Preventative measures can be taken by groups that are at risk for developing hematomas. These preventative measures include the following:

  • Special assistance, such as walking sticks or walking frames, may be used by the elderly to mitigate the risk of falling injuries.
  • One can abstain from alcohol. If not, special care should be taken to avoid serious injury while under the influence. For example, one must not drive after drinking alcohol.
  • Those with bleeding disorders can take prophylactic injections of clotting factor.

It should be noted that not all hematomas can be prevented. If one develops a hematoma, seek medical attention if the symptoms become severe or if the hematoma continues to grow.

 
 
 

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