What is an Intracerebral Hematoma?

An intracerebral hematoma is an uncommon yet life-threatening condition in which one or more blood vessels rupture in the brain. A hematoma is most likely to occur after a severe head injury, though drug overdoses, chronic hypertension, and blood disorders can also cause sudden bleeding. A person who suffers an intracerebral hematoma is likely to experience a severe headache, nausea, seizures, and even coma or death. Immediate surgical procedures are needed to attempt to relieve symptoms and prevent loss of brain functioning. After a successful procedure, long-term medications and regular checkups are needed to ensure that future problems do not develop.

Hematomas can appear with a sports injury, a car accident, a bad fall, or any activity in which the head is hit or jarred. In the absence of an injury, blood vessels can weaken and rupture because of high blood pressure, brain tumors, or certain blood diseases, such as hemophilia and anemia. Cocaine use and medications that thin the blood may also result in an intracerebral hematoma.

No matter the cause of an intracerebral hematoma, an individual typically experiences a number of telling symptoms. The most common symptoms are dizziness, confusion, nausea, and progressively worsening headaches. As blood and fluids build up in the brain, overall blood pressure tends to rise and the limbs on one or both sides of the body may feel weak or numb. Within minutes or hours, many people experience violent seizures that can lead to unconsciousness. Medical attention is necessary to identify the cause of the problem and remove excess blood from the brain before permanent damage is done.

When a patient is brought to an emergency room or critical care center, doctors first try to gather information about medical conditions and whether an accident had occurred. Specialists can determine the exact location of a hematoma by conducting a computerized tomography or magnetic resonance imaging scan of the brain. They can then decide on the safest and most effective treatment procedure.

Surgery is almost always necessary to relieve an intracerebral hematoma, although invasive procedures can cause additional brain damage in some cases. A minimally invasive procedure known as stereotactic surgery is often attempted, in which computer scans are used to pinpoint hematomas and guide the surgeon in inserting a small needle through the skull. The surgeon releases a chemical into the blood pool to thin it, and then uses a suction device to drain the fluid. Following surgery, a patient is usually confined to a hospital bed for several days or weeks to monitor recovery.