"Cerebral Hematoma: Symptoms, Causes, and Treatment Options"

2023-04-25 09:10:24

A cerebral hematoma can occur as a result of a stroke, vascular malformation or trauma. What are the warning symptoms? How to treat it? Resorb it? Can we die from it?

What is a cerebral hematoma?

The (intra)cerebral hematoma corresponds to a sudden accumulation of blood in the brain following the rupture of an arterial or venous vessel. The consequences of this hemorrhage vary according to the cause, the area in which it is located and the volume of the hematoma.

What are the symptoms of a brain hematoma?

“The symptoms generally depend on the location of the hematoma because certain parts of the brain are directly connected to certain functions”, says Dr. Bousquet, neurosurgeon. For example, a hematoma located in the occipital part of the brain (a lobe directly related to sight) can cause visual disturbances. A hematoma in the anterior part (frontal lobe) can lead to behavioral disturbances and confusion. Thus, the most common symptoms are:

A paralysis of half the body, called hemiplegia
A disturbance of the sensitivity of half of the body
Language disorders (aphasia)
Visual disturbances.
In the event of a ruptured arterial aneurysm, the first symptom is a severe headache.

Other symptoms related to the size of the hematoma may be seen. “If the clot occupies too large a volume, it can increase the pressure inside the skull. The patient then feels headaches and may even have impaired consciousness.“, continues our interlocutor.

What are the causes of a cerebral hematoma?

The main causes of a cerebral hematoma are:

► A cerebral vascular accident : “There are two main types of stroke: ischemic stroke, which corresponds to a clogged artery which causes the blood supply to an area of the brain to stop, and hemorrhagic stroke, which is less common, which corresponds to bleeding in the the brain often caused by another pathology.”

► Heart problems can be the cause of an ischemic stroke while untreated high blood pressure can be the cause of a hemorrhagic stroke. The occurrence of a hemorrhagic stroke can be favored by a disorder of blood coagulation, genetic or acquired (anticoagulant medication);

► Vascular malformations: There are several types. The most frequent are arterial aneurysms, arteriovenous malformations and cavernomas.

► A trauma, this is called cerebral contusion.

L’brain imaging allows the diagnosis of cerebral hematoma. “Sudden onset of brain-related symptoms raises suspicion of a stroke. Doctors then proceed to a scanner because this will allow the blood clot to be seen clearly in the form of a white area. Depending on the patient’s profile and the scan result, this will guide the diagnosis“, explains Dr. Bousquet. an MRI is very often carried out in addition to the scanner.

“A cerebral hemorrhage is a serious event that requires emergency treatment. The severity depends on the clinical situation, the location and the volume of the hematoma. The evolution is variable, ranging from an almost complete recovery to the death of the patient.

The treatment is most often medical and decided according to the cause. The objectives are, firstly, to normalize blood pressure and, secondly, correct any bleeding disorder to avoid rebleeding. It is also necessary to relieve the symptoms and prevent possible complications related to bed rest (bedsores, urinary tract infection, lung infection, etc.) Regarding the hematoma, this may resolve spontaneously. In some cases, surgery is planned to evacuate the hematoma if it endangers the patient’s life in the short term. “But in most cases, we don’t operate because the surgery can be more deleterious than the hematoma.“, specifies Dr. Bousquet. And to add “brain plasticity and rehabilitation work allows you to recover certain abilities“. However, cerebral hematoma can cause sequelae or even permanent loss of capacity.