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The truth behind severe headaches: What causes extracranial hematomas?
Extracranial hematoma, this term may be unfamiliar to many people, but its existence may be a signal of life-threatening danger. An extracranial hematoma is bleeding between the strong outer membrane that covers the brain (dura mater) and the skull. This condition is usually caused by head trauma, resulting in a fracture of the temporal bone and bleeding into the middle meningeal artery.
When bleeding occurs, people often regain consciousness briefly after a head injury and then lose consciousness again.
The main symptoms of extracranial hematoma include severe headache, confusion, nausea and vomiting, and may lead to inability to move the limbs. If not treated promptly, it can lead to serious complications, including seizures and even death.
Causes of extracranial hematoma
Head trauma is the most common cause of extracranial hematoma. According to medical research, extracranial hematomas account for about 10% of traumatic brain injuries, most of which are related to car accidents, assaults or accidental falls. Due to the traumatic effects of acceleration-deceleration and lateral forces, the area of the head that is usually injured is the temporal bone, which is relatively fragile and easily injured.
Extracranial hematomas can develop rapidly because of the high pressure of arterial bleeding, which usually peaks within 6 to 8 hours of injury.
When blood accumulates in the skull, it compresses internal structures and may further affect the third cranial nerve, causing the pupil on the injured side to become fixed and dilated. Additionally, patients experience a so-called "lucid interval" shortly after the injury, during which they appear normal, but then their symptoms rapidly worsen, an infection known as the "talk and die syndrome."
Diagnosis of extracranial hematoma
The diagnosis of extracranial hematoma usually relies on CT scan or MRI. Although CT scanning is the main tool for initial investigation, MRI should be used for more in-depth investigation if suspicion of extracranial hematoma is high. The key to diagnosis is the observation of "lucid periods" and subsequent loss of consciousness.
Extracranial hematomas usually appear convex in shape because their extension is limited by the sutures of the skull.
In patients with fractures, extracranial hematoma and subdural hematoma can occur simultaneously. CT scans show the presence of extracranial or subdural hematoma in approximately 20% of people who lose consciousness. It is worth noting that for patients who receive surgery in a timely manner, if the consciousness brightness is 15 points (the best condition), the prognosis is usually better.
Treatment of extracranial hematoma
Extracranial hematoma is a surgical emergency. Delaying surgery may result in permanent brain damage or even death. Surgery is usually done to remove the hematoma, usually by burr holes or craniotomy, to reduce pressure on the brain. In some cases, when referral to a surgical facility is inconvenient, ongoing trephination procedures may be performed in the emergency department.
If the volume of the extracranial hematoma is less than 30 ml, the clot diameter is less than 15 mm, and the patient's Glasgow Coma Scale score is higher than 8 points, conservative treatment can be considered.
After surgery, patients may need to take anti-seizure medications and osmotic pressure medications to reduce brain swelling and intracranial pressure. Experts emphasize that even if the symptoms of extracranial hematoma are mild, it still needs to be closely observed because it may expand rapidly in a short period of time. Both the prognosis of head trauma and the outcome of surgery are affected by many factors.
Conclusion
In summary, although extracranial hematoma is not the most common type of brain trauma, its potential danger should not be underestimated. It is important for patients and their families to understand the causes, symptoms, and treatments of extracranial hematomas. After suffering a head trauma, how to quickly identify the symptoms of extracranial hematoma and seek timely medical help is the key to protecting life. Are you prepared to deal with such a crisis?
