Hemorrhage and Hematoma

Hemorrhage vs Hematoma 

Bleeding is the loss of blood and there are two types of bleeding -- hemorrhage and hematoma. 

 

Hematoma is bleeding outside of blood vessels. The most common example is bruises. It is external within tissues and usually followed by clotting. 

 

Hemorrhage occurs when the blood vessels are ruptured and lead to acute bleeding. Hemorrhage can be both external or internal. 

 

Since there are many specific types of bleeding, this article will focus on hemorrhage and hematomas in the brain. 

 

Types of hematomas and symptoms 

  • Subdural hematomas: collection of blood between brain tissues and dura (a layer of tissue covered the brain) 

    • Headache, confusion, abnormal vision and speech, seizures, partial loss of body control 

  • Intracranial epidural hematoma: blood clots between skull and lining outside of brain tissue 

    • Backache, loss control of bladder and bowel, weakness 

  • Subarachnoid hematoma: bleeding between brain tissues and arachnoid (covering of the brain underneath dura) 

    • Loss of consciousness, nausea, vomiting 

  • Intracerebral hematoma: bleeding inside brain tissues

    • Headache, nausea, vomiting, weakness in one side of body, impaired speech, increased blood pressure

 

Types of hemorrhages and symptoms

  • Intracranial hemorrhage: elevated blood pressure lead to the rupture of arterial vessel in the brain

    • Weakness in one side of the body, headache, nausea, vomiting, change in mental state

  • Subarachnoid hemorrhage: rupture of veins in the brain causing blood clots in arachnoid and pia tissue (layering of the brain underneath arachnoid) 

    • Serve headache (“worst headache in my life”) 

  • intraparenchymal hemorrhage: rupture of blood vessels in brainstem (pons, medulla and cerebellum) and basal ganglia 

    • Headache, nausea, vomiting, confusion, altered visions, seizures, weakness 

 

Causes and risk factors 

  • Trauma: car accidents, sudden falls, violent attack against the head, sports

  • Family history

  • Hypertension

  • Heavy alcohol and cigarette use

  • Medication such as blood thinners, aspirin, ibuprofen, Ginkgo biloba, Vitamin E and garlic supplements

  • Drug use such as amphetamines and cocaine 

  • Bleeding disorders

  • Seizures

 

Diagnosis

Obtaining medical history and uses of medications of patients are very helpful for medical professionals. Then health care providers will perform physical exams to narrow the sites of bleeding. For injury in the head, CT and MRI scans are necessary. X-ray is also used for bleeding in the chest and abdomen. 

 

Treatment 

Medical professionals will try to maintain blood pressure with steroids. Anticoagulants are used to reduce blood clotting. If patients have seizures, anti seizure medicine is also used. Surgery may be needed. Further medication and observation are necessary. 

 

Respond to hematoma and hemorrhage

  • R: rest

  • I: apply ice for 20 minutes at a time 

  • C: compress the site of bleeding using elastic bandages 

  • E: elevate the area of bleeding above the heart

  • Notice: this RICE aid can only be used for minor hematoma and hemorrhage. If serious symptoms such as large amounts of blood loss, unconsciousness, seizures and more occur, please seek professional medical help. 

 

Reference

Brain Hemorrhage (Bleeding): Causes, Symptoms, Treatments. (n.d.). Retrieved from https://www.webmd.com/brain/brain-hemorrhage-bleeding-causes-symptoms-treatments

Danette C. Taylor, D. (2019, September 10). Brain Hemorrhage Symptoms, Treatment, Causes & Survival Rates. Retrieved from https://www.medicinenet.com/brain_hemorrhage/article.htm

Han, S. (2018, December 7). Intracranial Hemorrhage. Retrieved from https://www.healthline.com/health/extradural-hemorrhage

John P. Cunha, D. (2020, April 02). Hematoma vs. Hemorrhage Differences in Symptoms & Outcomes. Retrieved from https://www.emedicinehealth.com/hematoma_vs_hemorrhage/article_em.htm

Johnson, A. B. (2020, November 16). Hemorrhage. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK542273/

Mayfield. (2018, April). Intracerebral hemorrhage (ICH). Retrieved from https://mayfieldclinic.com/pe-ich.htm

Publishing, H. H. (n.d.). Subdural Hematoma. Retrieved from https://www.health.harvard.edu/a_to_z/subdural-hematoma-a-to-z

Siamak N. Nabili, M. (2016, May 02). Hematoma: Types, Symptoms, Pictures, Causes & Treatments. Retrieved from https://www.rxlist.com/hematoma/drugs-condition.htm

Resources by Cassie Wang

Voices of Brain Injury

  • Instagram @voices_of_braininjury

Instagram @voices_of_braininjury

Bridging the gap between public and brain injury community through shared narratives.