Hematomas 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 themselves. However, major bruising can put pressure on the brain, causing pain.
Bleeding in the head differentiates between different types:
- Epidural hematoma
- Subdural hematoma
- subarachnoid hemorrhage
- Intracerebral hematoma
An epidural hematoma (EDH) has a hematoma between the skull and the outer meninges. Cause is often a cranial trauma, which is associated with an arterial injury. An epidural hematoma is very dangerous, about 15 to 20 percent of those affected do not survive such an injury. To relieve the pressure of bruising on the brain, an epidural hematoma above a certain size must be surgically removed.
A subdural hematoma (SDH) is closer to the brain than an epidural hematoma because it is located under the outer meninges. It arises when it comes to injuries to the so-called bridge veins - in the elderly, such an injury is possible without external violence. Larger subdural hematomas also need to be surgically removed.
If a hematoma occurs between the soft meninges surrounding the brain and the spiderweb skin above, this is called subarachnoid hemorrhage. The cause of such an injury, which is manifested by severe headaches, neck stiffness, as well as nausea and vomiting, is usually a burst brain aneurysm.
In such a case, the patient must be promptly operated on. In a subarachnoid hemorrhage, about 50 percent of those affected die within the first month after the bleeding, in the other patients it often leads to coordination disorders or a limitation of mental performance.
If a bruise forms directly in the brain, this is called an intracerebral hematoma. Such an injury causes symptoms such as paralysis, speech and visual disturbances, nausea and vomiting. Depending on the size of the bleeding, there is an acute danger to the patient's survival. Surgery can not always save the patient's life from such an injury.