The president of Brazil had to be hospitalized urgently last Tuesday to drain an intracranial hematoma.
A intracranial hemorrhage can be both within the brain itself (known as intracerebral hemorrhage or intraparenchymal hematoma) or between the brain and the skull bone. The latter occur between the membranes that cover the brain called meninges and they take their name depending on which of these occur: subarachnoid hemorrhage (between arachnoid and pia mater), subdural hematoma (between dura mater and arachnoid mater) or extradural hematoma (between dura mater and skull bone). Each type of intracranial hemorrhage has its own most common causes and its own management (although the latter depends on each particular case as well). The diagnosis of the different intracranial hemorrhages is made by imaging studiesboth tomography and magnetic resonance imaging, the use of the former being more frequent in these cases.
He subdural hematoma It is a type of hemorrhage that in almost all cases has its origin in a head trauma. It is often diagnosed time after trauma. This occurs because initially the acute subdural hematoma is a firm blood clot that is thin. can be reabsorbed on its own (and even not generating symptoms), but in other cases this does not happen but rather evolves into a chronic subdural hematoma. In this process, its size progressively increases both due to the accumulation of water in the subdural space (due to an osmotic effect) and due to small rebleeding from the wall of the hematoma itself. Then there comes a time when the hematoma begins to compress the underlying brain and generate symptoms such as: headache, difficulty moving one or more limbs, speech problems, drowsiness, sensory alterations, among others. During the transition from acute subdural hematoma to the subacute stage and then to the chronic stage, it ceases to have a firm consistency and becomes liquid, ending up with an appearance similar to that of car oil.
Symptomatic subdural hematomas, as well as those that have greater thickness or volume, should be surgically evacuated. The surgical strategy depends on the consistency of the hematoma and its location. More solid hematomas (acute) require a craniotomy; that is, a window in skull bonewhich is then closed again by fixing the bone with different methods. Chronic subdural hematomas, when having liquid consistencycan be evacuated through two holes made in the skull without requiring the performing a craniotomywhich is a larger surgical approach. Subacute subdural hematomas (that is, at an intermediate stage between acute and chronic) may have a more solid or more liquid consistency depending on each case and therefore, the neurosurgeon decides his strategy according to each individual patient.
Source: Ambito
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