Hematoma is an abnormal collection of blood outside the blood vessels, which can be characterized by the appearance of a lump or a purplish red skin.A hematoma occurs when a blood vessel is damaged, causing blood to leak into the tissue (bleeding).
Hematomas can occur anywhere on the body, such as under the nails, under the scalp, inside the earlobe, or most dangerously in the brain.
If it's small, usually the bleeding will stop on its own, so it doesn't require special treatment. However, in some cases, a hematoma can cause an emergency that requires immediate medical attention.
Types of Hematoma
Based on their location, hematomas are divided into:
- Intracranial hematoma, which occurs due to damage to blood vessels in the skull, both blood vessels around the protective layer of the brain (epidural, subdural, or subarachnoid hematoma) or within brain tissue (intracerebral hematoma)
- Scalp hematoma, which occurs due to damage to the blood vessels located between the scalp and skull
- Ear hematoma, which occurs when the blood vessels under the skin of the ear are damaged and can cause the ear tissue to die
- Nasal septal hematoma, which usually occurs due to a nose injury
- Intramuscular (inside muscle tissue) hematomas, which usually result from fractures
- Subungual hematoma (under the nail), which usually results from an injury to a finger or toe
- A subcutaneous hematoma, which occurs as a result of injury to the blood vessels under the skin and causes bruising and bruising
- Intra-abdominal hematoma, which occurs due to bleeding in the abdominal cavity
Causes and Factors Ririsk of hematoma
A common cause of a hematoma is an injury, such as from an accident, fall, bump, sprain, fracture, or gunshot wound. In some cases, sneezing too hard can also cause injury to the small blood vessels in the nose.
In addition, there are also several things that can increase a person's risk of experiencing a hematoma, namely:
- old age
- Suffering from an aneurysm, which is an abnormal widening of the blood vessels that causes the walls of the blood vessels to become thinner and tear more easily
- Taking certain medications, such as anticoagulants, which can reduce the body's ability to form blood clots and repair damaged blood vessels
- Suffering from conditions that cause a low platelet count or loss of platelet function, such as viral infections and aplastic anemia
Symptoms of Hematoma
Symptoms experienced by each patient can be different, depending on the location, size, and severity of the hematoma suffered. If the hematoma is close to the surface of the skin, symptoms may include:
- Lumps or swelling
- Purplish red skin
- Black nails (subungual hematoma)
- Skin feels warm to the touch
- Pain
Hematomas that are deeper or closer to organs may not be visible, but they can cause more severe symptoms. Based on the type, the following are examples of symptoms that can occur:
Intracranial hematoma
Hematoma that occurs in the skull can cause increased pressure in the head so that it compresses brain tissue. This can cause several symptoms, such as:
- Great headache
- Throw up
- Half body muscle weakness
- Loss of consciousness
- Seizures
Intra-abdominal hematoma
In the hematoma that occurs in the abdomen, the symptoms that can be experienced by sufferers are:
- Stomach pain
- Low back pain
- Nausea and vomiting
- Lump on the abdominal wall
- Bruises on the skin of the stomach
Because the abdominal cavity is wide, more blood can flow into this cavity, so the hematoma that forms can be even larger. This increases the risk of developing low blood pressure and shock from excessive blood loss.
When to go to the doctor
Hematoma can be a serious condition, depending on its location and severity. Therefore, seek medical attention immediately if you experience the symptoms of an intracranial or intra-abdominal hematoma as above.
In addition, consult your doctor if you experience any of the following conditions:
- Having an injury and taking blood-thinning medication, especially if the injury is to the head
- Getting blood clots in the urine
- Difficulty moving limbs that have a hematoma
- Hematoma continues to enlarge or expand
Hematoma Diagnosis
In hematomas that occur on the surface of the skin or soft tissues, such as joints and muscles, the diagnosis can be made by asking questions about the symptoms experienced, history of injury, and the patient's medical history. A physical examination will also be performed, especially in the area where the hematoma is located.
To diagnose an invisible hematoma, additional investigations are needed, such as:
- CT scan, to see hematomas in the brain
- Ultrasound, to see hematomas in the abdominal cavity
Follow-up examinations are also needed to determine the causes, risk factors, or complications that may have occurred. These inspections can be in the form of:
- X-ray, to determine whether there is a fracture due to a hematoma
- Blood tests, to determine platelet levels and blood clotting time
Hematoma Treatment
Hematoma treatment is adjusted to the severity, location, and condition of the affected limb due to the hematoma. For hematomas that appear on the skin and soft tissues, doctors will usually only recommend the RICE technique (rest, ice, compression, elevation) as follows:
- rest
Rest the affected body part as often as possible to speed healing and prevent further damage.
- Ice
Compress the hematoma area with ice cubes wrapped in a towel to relieve swelling.
- Compression
Wrap the area or part of the body that has a hematoma with an elastic bandage to stop the bleeding and reduce swelling.
- Elevation
Elevate the part of the body affected by the hematoma higher than the heart when lying down. This is useful for relieving pain, throbbing, and swelling.
In addition to the methods above, doctors can also give pain relievers. However, its use must be in accordance with the instructions of the doctor.
Treatment of hematomas on other parts of the body depends on the location and size of the hematoma. If the hematoma is very large and interferes with the structure or function of nearby organs, surgery may be necessary to remove the pool of blood.
For example, a craniotomy may be performed to treat an intracranial hematoma that has expanded. In the process, the doctor will open the skull bone to remove the pool of blood.
Hematoma Complications
Hematomas can cause complications if the bleeding continues, is large, or presses on important organs. These complications include:
- Low blood pressure
- Shock
- Permanent brain damage
- Infection
- Compartment syndrome (in intramuscular hematomas)
Hematoma Prevention
The best way to prevent a hematoma is to prevent injury. If indeed you work in a field that has a high risk of causing injury, such as athletes or construction workers, use complete protective equipment when working.
In addition, if you are taking blood-thinning drugs (anticoagulants), make sure the dosage you take is according to the doctor's recommendations.