Understanding What an Internal Hematoma Is
An internal hematoma is a localized collection of blood outside of blood vessels, often caused by trauma. Unlike a superficial bruise (contusion), which involves smaller capillaries and discolors the skin, a hematoma results from a larger leak from bigger blood vessels, causing a pooling effect and often a palpable lump. The severity and treatment depend largely on its location and size.
Common Causes of Hematomas
Hematomas frequently arise from a traumatic event where blunt force impacts the body, damaging underlying blood vessels. Some common causes include:
- Car accidents or falls
- Bone fractures or severe muscle strains
- Medical procedures, such as surgery or catheter insertion
- Underlying medical conditions that affect blood clotting, like hemophilia or liver disease
- Blood-thinning medications (anticoagulants), which increase the risk of bleeding
Initial Assessment: When to Seek Medical Help
While many small, surface-level hematomas are harmless and heal on their own, certain signs indicate the need for immediate medical attention. The location of the hematoma is a critical factor. For example, a hematoma in the skull (intracranial) is far more serious than one on a muscle (intramuscular).
Warning Signs and Symptoms
Contact a healthcare professional immediately if you experience any of the following, especially after an injury:
- Sudden, severe headache
- Weakness, paralysis, or numbness on one side of the body
- Nausea, vomiting, or dizziness
- Vision changes or unequal pupil size
- Confusion, slurred speech, or seizures
- A bruise that continues to grow in size or pain after several days
- Difficulty breathing or chest/abdominal pain
Conservative Management for Minor Cases
For smaller, less severe hematomas located in non-critical areas, conservative treatment can help manage symptoms and support the body's natural healing process. The body typically reabsorbs the blood over several weeks or months.
The R.I.C.E. Method
The R.I.C.E. (Rest, Ice, Compression, Elevation) method is a standard approach for superficial hematomas and injuries.
- Rest: Avoid using the injured area to prevent further damage and allow the healing process to begin. For an injured limb, this means minimizing movement and strenuous activity.
- Ice: Apply a cold pack wrapped in a cloth to the area for 15–20 minutes several times a day for the first 24–48 hours. This helps reduce swelling and pain.
- Compression: Use an elastic bandage to gently wrap the injured area. This minimizes swelling but should not be so tight as to cause numbness or increased pain.
- Elevation: Prop the injured area above the level of your heart. This uses gravity to help reduce swelling.
Medical and Surgical Interventions
When a hematoma is large, symptomatic, or located in a dangerous area like the head, urgent medical intervention is required. Doctors use imaging tests like CT scans or MRIs to assess the size and location of internal hematomas.
Procedures for Hematoma Treatment
- Needle Aspiration: A healthcare provider may use a needle and syringe to drain the pooled blood, especially for superficial but large hematomas.
- Incision and Drainage: For more significant or clotted hematomas, a surgeon may need to make an incision to drain the blood and debris.
- Craniotomy: In cases of severe intracranial hematomas, a neurosurgeon may perform a craniotomy—temporarily removing a piece of the skull to access and remove the blood clot and relieve pressure on the brain.
- Embolization: This procedure blocks the blood supply to the affected vessel to prevent further bleeding.
Conservative vs. Surgical Management Comparison
| Feature | Conservative Management | Surgical Management |
|---|---|---|
| Best For | Small, superficial hematomas with minor symptoms | Large, internal, or expanding hematomas causing severe symptoms |
| Procedures | R.I.C.E., observation, pain medication (e.g., acetaminophen) | Needle aspiration, incision and drainage, craniotomy, embolization |
| Healing Time | Weeks to months, as the body gradually reabsorbs the blood | Often faster relief of pressure; overall recovery depends on the underlying injury and procedure |
| Key Risk | Possible complications if a serious underlying issue is missed | Surgical risks like infection, bleeding, and anesthesia complications |
Preventing Complications and Promoting Recovery
Properly managing an internal hematoma is crucial for avoiding complications and ensuring a full recovery. Ignoring a serious hematoma, especially in the head, can lead to permanent damage or death.
Potential Complications of Internal Hematomas
- Infection: A pooled collection of blood can become a breeding ground for bacteria.
- Pressure on Nerves: A hematoma can swell and press on nearby nerves, causing numbness, tingling, or weakness.
- Compartment Syndrome: In severe cases, a hematoma can cause swelling within a confined space (like a muscle compartment), cutting off blood supply and damaging tissue.
- Calcification: The hematoma can harden over time, forming a permanent calcified lump.
Post-Treatment Care and Rehabilitation
After medical or surgical treatment, follow your doctor's instructions carefully. This may include:
- Restricting activity to allow for proper healing.
- Taking prescribed medications for pain and any underlying conditions.
- Engaging in physical therapy or rehabilitation to restore mobility and function.
- Attending follow-up appointments and imaging studies to monitor the hematoma's resolution.
- Wearing protective gear to prevent re-injury.
Conclusion
Knowing how to get rid of an internal hematoma means recognizing that while small ones may resolve naturally, serious cases require prompt medical attention. Proper diagnosis is key to determining the right course of action, which could range from simple observation to complex surgical procedures. By understanding the symptoms and seeking timely help, you can ensure a safer and more effective recovery. For more information, please consult a trusted medical resource like the Cleveland Clinic.
