Some hematomas don't need to be removed because they're small and produce no signs or symptoms. But because signs and symptoms may appear or worsen days or weeks after the injury, if you don't have surgery, you may have to be watched for neurological changes, have your intracranial pressure monitored and undergo repeated head CT scans.
If you take blood-thinning medication, such as warfarin, you may need therapy to reverse the effects of the medication and reduce the risk of further bleeding. Options for reversing blood thinners include administering vitamin K and fresh frozen plasma.
Hematoma treatment often requires surgery. The type of surgery depends on the characteristics of your hematoma. Options include:
- Surgical drainage. If the blood is localized and isn't clotting excessively, your doctor may create a burr hole through your skull and use suction to remove the liquid.
- Craniotomy. Large hematomas may require that a section of your skull be opened (craniotomy) to remove the blood.
After surgery, your doctor may prescribe anticonvulsant drugs for up to a year after the trauma to control or prevent post-traumatic seizures. Long-term anticonvulsant therapy may be needed if seizures continue.
Other conditions that may continue for some time after surgery include:
- Attention difficulties
- Sleep problems
Recovery after an intracranial hematoma can be prolonged and may be incomplete. If you continue to have neurological problems after treatment, you may need occupational and physical therapy.
Jun. 25, 2014
- Traumatic brain injury: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/tbi/detail_tbi.htm. Accessed April 14, 2014.
- Traumatic brain injury. The Merck Manuals: The Merck Manual for Health Care Professionals. http://www.merck.com/mmpe/sec21/ch310/ch310a.html#S21_CH310_T001. Accessed April 14, 2014.
- McBride W. Intracranial epidural hematoma in adults. http://www.uptodate.com/home. Accessed April 14, 2014.
- McBride W. Subdural hematoma in adults: Prognosis and management. http://www.uptodate.com/home. Accessed April 14, 2014.
- Ahn ES, et al. Intracranial epidural hematoma in children: Clinical features, evaluation and management. http://www.uptodate.com/home. Accessed April 14, 2014.
- Wind JJ, et al. Bilateral subacute subdural hematomas. New England Journal of Medicine. 2009;360:e23.
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