Hematomas that are small and produce no signs or symptoms don't need to be removed. But because signs and symptoms can appear or worsen days or weeks after the injury, you might 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 involves surgery. The type of surgery depends on the type of hematoma you have. Options include:
- Surgical drainage. If the blood is localized and isn't clotting a lot, your doctor might create a burr hole through your skull and use suction to remove the liquid.
- Craniotomy. Large hematomas might require that a section of your skull be opened (craniotomy) to remove the blood.
Recovery after an intracranial hematoma can take a long time, and you might not recover completely. The greatest period of recovery is up to three months after the injury, usually with lesser improvement after that. If you continue to have neurological problems after treatment, you might need occupational and physical therapy.