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Traumatic brain injuries and hematomas

Traumatic brain injuries and hematomas Copyright Ray Evans

Copyright Ray Evans
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Most brain injuries come through trauma such as a car accident, a fall, a gunshot or a blow to the head. Dr. Foroohar treats brain injury and hematoma patients at Northwest Community Hospital in Arlington Heights, Illinois, and offers follow-up care through her office.

What is a traumatic brain injury?

A traumatic brain injury is simply an injury to the brain caused by physical trauma to the head. Traumatic brain injuries can result in several types of internal bleeding or hematoma (hemorrhage) in the brain:

  • An epidural hematoma involves bleeding outside the dura—the outer covering of the brain just underneath the skull. Epidural hematomas can be deadly; they are associated with skull fractures and most often result from arterial bleeding (bleeding from an artery).

  • A subdural hematoma involves bleeding between the dura and the brain. This condition is very common, especially among older adults. It most often results from venous bleeding (bleeding from a vein). Subdural hematomas are further classified according to their age:

    • Acute subdural hematomas are the result of fresh bleeding. This condition is often associated with underlying brain injury and brain contusions (bruising).
    • Subacute subdural hematomas are often four days to two to three weeks old.
    • Chronic subdural hematomas are usually over three weeks and less than three to four months old.

    The age, size and compression of the underlying brain from the subdural hematoma determine the urgency of treatment. With any age or size of subdural hematoma, it is important to seek immediate medical care.

  • An intracerebral hematoma involves bleeding within the brain itself. This type of bleeding can result from trauma as well as other causes, including:

    • High blood pressure
    • Vascular malformation
    • Blood thinners such as Coumadin (warfarin), Plavix or aspirin
    • Tumors
    • Amyloid (pronounced AM uh loid) angiopathy, a neurological condition in which proteins called amyloid build up on the walls of the brain's arteries

    • Stroke

  • A subarachnoid hemorrhage sometimes results from trauma. The arachnoid (pronounced uh RACK noid) is a web of fine tissue attached to the brain's surface. This type of hemorrhage can also result from a ruptured cerebral aneurysm, which requires immediate medical attention.

Brain hemorrhages may or may not be related to trauma.

Traumatic and non-traumatic brain hemorrhages can cause swelling of the brain.

Brain swelling can result from:

“Brain swelling, in and of itself, is not a diagnosis,” Dr. Foroohar explains. “It's more the result of something else.”

Dr. Foroohar answers questions
about traumatic brain injuries and hematomas

How do you treat swelling in the brain?

To treat increased pressure in the head, for whatever reason—whether a gunshot, a stroke or hemorrhage—we can:

  • Place a monitor in the head
  • Place a drain in the head
  • Remove part of the skull to create room for the brain
  • Remove the hematoma (hemorrhage)
  • Remove the underlying cause of swelling, such as a tumor or infection
  • Remove part of the brain

If you have to remove part of the skull, what do you do with the piece
that was removed?

When part of the skull is removed, we extend and create a new brain covering and close the scalp over it. We then store the bone temporarily under the skin in the patient's abdomen. Once the swelling has gone down, we operate again to put the bone section back in place.

For more information or to schedule an appointment, call 847.398.9100
Or email info@northwestneurosurgery.com.