Is hematoma considered internal bleeding?

September 29, 2025 •

4 min read

Approximately 1 in 5,000 people develop a serious, spontaneous hematoma annually. Understanding the distinction between a hematoma and ongoing bleeding is critical, as the answer to 'Is hematoma considered internal bleeding?' is yes, though with important nuances.

Quick Summary

A hematoma is a localized collection of blood, often clotted, outside a blood vessel, which is a specific type of internal bleeding. While all hematomas represent internal bleeding, not all internal bleeding is a hematoma; the latter involves a contained, pooled collection, while a hemorrhage is active, ongoing bleeding.

Key Points

Hematoma vs. Hemorrhage: A hematoma is a pooled collection of blood (clotted or clotting), which is a specific type of internal bleeding, while a hemorrhage is active, ongoing internal bleeding.
Location is Key: The severity of a hematoma is highly dependent on its location; a minor bruise is a subcutaneous hematoma, whereas an intracranial hematoma is a serious medical emergency.
Caused by Leaking Blood Vessels: A hematoma forms when trauma or an underlying condition causes a blood vessel to break, allowing blood to leak into surrounding tissue.
Trauma is the Most Common Cause: Significant injuries like falls, accidents, or blows to the head are frequent causes, but even minor events like a sneeze can cause small hematomas.
Look for Warning Signs: Severe pain, rapid expansion of a hematoma, confusion, or vision changes after an injury can indicate a serious problem that requires immediate medical attention.
Diagnosis Through Imaging: Doctors use CT scans, MRIs, or ultrasounds to diagnose and assess internal hematomas.

What Exactly is a Hematoma?

A hematoma is a collection of blood that has leaked from a damaged blood vessel and pooled in the surrounding tissues. This pooling can occur almost anywhere in the body, from just beneath the skin to deep within organs or muscles. A simple bruise, or ecchymosis, is a common and minor form of a hematoma, representing a small collection of blood from tiny, broken capillaries.

However, hematomas can be far more serious than a simple bruise, especially if they occur in vital areas like the brain. The size and location determine the severity, with larger or deeper hematomas potentially causing significant pressure and damage to nearby tissues and organs.

Hematoma vs. Hemorrhage: The Critical Distinction

While a hematoma is a form of internal bleeding, it is not the same as a hemorrhage. The key difference lies in the nature of the bleeding: a hemorrhage signifies active, ongoing bleeding, whereas a hematoma is the result of that bleeding having accumulated and often clotted within a contained space.

Think of it this way: a hemorrhage is the process of a leaking faucet, while a hematoma is the puddle of water that has collected on the floor. In a hemorrhage, the bleeding continues, but in a hematoma, the bleeding has typically stopped or slowed significantly, with the blood pooling in one area.

How Hematomas Form

Damage to a blood vessel wall, whether from a traumatic injury, a medical procedure, or an underlying health condition, allows blood to leak out. The greater the initial bleeding, the larger the hematoma that can form. The body’s natural clotting process is crucial for stopping this leak. If the damage is extensive or the person has a clotting disorder, the bleeding may continue, and the hematoma can expand over time.

Factors That Increase the Risk of Hematoma

Several factors can increase an individual's risk of developing a hematoma, including:

Taking anticoagulant (blood thinner) medications such as warfarin or aspirin.
Having a blood clotting disorder like hemophilia.
Older age, as blood vessels become more fragile with time.
Undergoing certain surgical procedures.
High blood pressure, which can lead to spontaneous vessel rupture.
Underlying conditions like blood cancers or severe liver disease.

A Closer Look at Different Types of Hematomas

Hematomas are often classified by their location in the body, which dictates their potential severity and symptoms. Some of the most common types include:

Subcutaneous Hematoma: This occurs under the skin, most commonly known as a bruise. It typically resolves on its own.
Subdural Hematoma: A very serious condition, this is a blood collection between the outer lining of the brain (dura) and the brain itself, often from a head injury.
Epidural Hematoma: Bleeding occurs between the skull and the dura mater, frequently caused by a major head trauma.
Intramuscular Hematoma: A collection of blood within the muscle tissue, often painful and accompanied by swelling.
Subungual Hematoma: A hematoma that forms under a fingernail or toenail, usually caused by trauma.
Retroperitoneal Hematoma: Occurs in the retroperitoneal space behind the abdominal cavity, often from trauma or surgery.

Comparison: Hematoma vs. Hemorrhage


Feature	Hematoma	Hemorrhage
Bleeding Status	Pooled, contained, and often clotted blood.	Active, ongoing bleeding from a ruptured vessel.
Appearance	May present as a raised, firm lump or significant discoloration.	Often not visible externally if internal; can be profuse if external.
Timing	Accumulates over time as blood leaks and clots.	Occurs at the time of rupture and continues until stopped.
Urgency	Can be serious, but severity depends on size and location.	Often a medical emergency, especially if severe or internal.
Location	Localized to a specific area in tissue or body space.	Can be localized or spread throughout a body cavity.
Treatment	May involve rest, ice, or drainage in severe cases.	Requires immediate medical intervention to stop the bleeding.

Diagnosis and When to Seek Medical Attention

For superficial hematomas, diagnosis is often straightforward and based on physical examination. However, for internal hematomas, a doctor may order imaging tests, such as a CT scan, MRI, or ultrasound, to determine the location, size, and potential impact on surrounding structures.

While most minor hematomas, like a bruise, heal on their own, it is crucial to seek prompt medical care if you suspect a serious internal hematoma. Warning signs can include a rapidly expanding hematoma, severe pain, or symptoms related to pressure on vital organs, such as a severe headache, confusion, or difficulty breathing.

If you have suffered a significant injury, especially to the head, abdomen, or a large muscle group, do not hesitate to contact a healthcare provider. Recognizing the symptoms of a serious internal hematoma can make a lifesaving difference. For more details on various types of hematomas and their specific management, reliable resources like the Cleveland Clinic offer extensive, expert-vetted information on a wide range of health topics related to hematomas and other conditions.

Conclusion: The Final Word on Hematomas and Internal Bleeding

To answer the question, is hematoma considered internal bleeding?, the answer is yes, a hematoma is a form of internal bleeding. However, it is distinct from a hemorrhage, which is active, continuous bleeding. A hematoma is a localized, pooled collection of blood that has leaked from a vessel. This distinction is vital for understanding the nature of an injury and determining the appropriate medical response. Always consult a healthcare professional if you have concerns about a hematoma, particularly after a significant injury or if you experience severe or worsening symptoms.

Frequently Asked Questions

Not necessarily. A minor hematoma, like a common bruise under the skin (subcutaneous hematoma), is usually harmless and resolves on its own. However, a hematoma in a critical area, such as the brain, is a serious medical emergency. The severity depends on its size, location, and the cause.

A bruise (ecchymosis) is a type of minor hematoma caused by bleeding from small capillaries just under the skin. A hematoma is a larger, more localized collection of blood, often from a larger vessel, and can occur deeper within the body, sometimes causing a lump.

For internal hematomas, doctors use imaging techniques such as a CT scan, MRI, or ultrasound to visualize the collection of blood and assess its size and impact on surrounding tissues.

Superficial hematomas cause discoloration, swelling, and tenderness. For internal or intracranial hematomas, symptoms can be more severe and include intense pain, confusion, weakness, or even loss of consciousness, depending on the location.

Yes, while trauma is the most common cause, hematomas can also result from medical conditions like clotting disorders, use of blood thinners, aneurysms, or even spontaneously in some cases.

Treatment for a serious hematoma depends on its size and location. Minor ones may only require rest, ice, compression, and elevation (RICE). In severe cases, especially those causing pressure on vital organs, surgical drainage of the blood may be necessary.

Yes, if the underlying bleeding has not fully stopped, the hematoma can continue to expand. In some cases, a chronic hematoma can develop, which may require ongoing medical attention.