hematomas

Cranial Hematoma. The two most common kinds of cranial hematomas are epidural and subdural (dural refers to the dura mater). Epidural hematoma occurs between the dura mater and the skull. It is most often caused by a heavy blow to the head that damages the upper surface of the dura mater. Blood seeps into the surrounding tissue, forming a tumorlike mass or hematoma. Since the skull is rigid, the hematoma presses inward against the brain; if the pressure continues, the brain can be affected. An epidural hematoma is the result of rupture of a relatively large meningeal artery, so that there is a rapid leakage of blood, causing increased intracranial pressure that can be fatal in a short period of time.

A subdural hematoma occurs beneath the dura mater, between the tough casing and the more delicate membranes covering the tissue of the brain, the pia-arachnoid. This kind of injury is more often caused by the head striking an immovable object, such as the floor, than by a blow from a moving object. There may be no severe head injury or fracture. A blow to the head can cause the brain to move violently, tearing blood vessels and forming a swelling that may include fluid from the brain tissue. A chronic subdural hematoma may remain and increase in size. (See also head injury.)

Septal Hematoma. Injury to the nose sometimes causes hematoma of the nasal septum. Its symptoms include nasal obstruction and headache. The condition may be treated by incision and drainage or may clear up spontaneously in a few weeks. If the hematoma becomes infected, an abscess may result, requiring drainage and treatment with antibiotics.