What will a doctor do for a hematoma? A guide to medical treatments

September 29, 2025 •

4 min read

While most minor hematomas resolve on their own, a doctor's intervention is sometimes necessary for larger or more serious cases. The specific actions a doctor will take for a hematoma are based on its size, location, and underlying cause.

Quick Summary

A doctor evaluates a hematoma through a physical exam and imaging to determine the best course of action. Treatment can range from observation and conservative care (RICE method) for minor cases to draining the blood via needle aspiration or surgery for larger, painful, or dangerous hematomas, especially those affecting the brain or other critical areas.

Key Points

Diagnosis is First: A doctor first evaluates a hematoma's severity and location using a physical exam and imaging like CT scans or ultrasound.
R.I.C.E. for Mild Cases: For small, superficial hematomas, doctors advise conservative management, including rest, ice, compression, and elevation.
Draining is an Option: Large or painful hematomas may require drainage, which can be done with a needle (aspiration) or a small surgical incision.
Surgery for Severe Cases: Severe cases, such as intracranial hematomas pressing on the brain, require surgery to drain the blood and relieve pressure.
Monitoring is Crucial: After treatment, follow-up care and monitoring are essential to prevent complications and ensure proper healing.

How a doctor diagnoses a hematoma

When you see a healthcare provider for a hematoma, their first priority is a thorough diagnosis to understand the severity and location of the blood collection. The diagnostic process typically involves several steps.

Medical history and physical examination

Your doctor will begin by asking about your symptoms, any recent injuries or procedures, and your overall medical history. This includes questioning any medications you may be taking, especially blood thinners, which can affect clotting. During the physical exam, the doctor will inspect and feel (palpate) the affected area, assessing the size, tenderness, and characteristics of the swelling. They will also check for any signs of neurological issues if a head injury is involved, or assess range of motion for a limb hematoma.

Imaging studies

Depending on the suspected location and depth of the hematoma, a doctor may order one or more imaging studies to visualize the extent of the blood pooling.

Ultrasound: Uses sound waves to create images of superficial hematomas and assess their size and characteristics.
Computed Tomography (CT) Scan: Utilizes X-rays to create cross-sectional images, making it useful for diagnosing deeper hematomas, particularly intracranial ones affecting the brain.
Magnetic Resonance Imaging (MRI): Provides detailed images of soft tissues, offering valuable information about the hematoma's location and impact on surrounding structures.

Blood tests

If there's a concern about an underlying bleeding or clotting disorder, blood tests may be ordered to evaluate blood function.

Medical treatment options for a hematoma

Based on the diagnosis, a doctor will decide on the most appropriate treatment plan. This can range from simple observation to advanced surgical procedures.

Conservative management for minor hematomas

For small, superficial hematomas that are not causing significant complications, a doctor will often recommend conservative, at-home care. This typically includes the R.I.C.E. method:

Rest: Avoid further injury to the area to allow for healing.
Ice: Apply cold compresses to the area to reduce swelling and pain.
Compression: Wrap the area with an elastic bandage to provide support and prevent further blood leakage.
Elevation: Keep the affected area elevated above the heart to decrease blood flow and reduce swelling.

Drainage and aspiration for larger hematomas

Larger or more symptomatic hematomas may require drainage to relieve pressure, reduce pain, and speed up the healing process. Aspiration involves using a needle and syringe to carefully withdraw the pooled blood under sterile conditions. For some complex hematomas, particularly those from surgery, an incision may be made to remove the clotted blood.

Surgical intervention for severe cases

Surgical intervention is necessary for large, rapidly expanding, or complicated hematomas, especially those causing pressure on vital organs like the brain or spinal cord. Common surgical procedures include:

Burr hole surgery: A small hole is drilled into the skull to drain a hematoma pressing on the brain.
Craniotomy: A larger section of the skull is removed temporarily to access and remove a significant intracranial hematoma.
Ligation: Surgically tying off a bleeding blood vessel to stop the leak.

Comparison of treatment approaches


Feature	Conservative Management	Aspiration/Drainage	Surgical Intervention
Best for	Minor, superficial hematomas.	Large, painful, or slow-to-resolve hematomas.	Expanding, large, or intracranial hematomas.
Primary Goal	Natural reabsorption of blood by the body.	Immediate relief of pressure and pain.	Removal of blood clots and repair of damaged vessels.
Procedure	Rest, ice, compression, elevation (RICE).	Needle and syringe or small incision.	Invasive surgery (e.g., burr hole, craniotomy).
Recovery	Days to weeks; self-care at home.	Quick recovery; follow-up care needed.	Longer recovery; hospital stay may be required.
Risks	Low; minimal complication risk.	Risk of infection, re-bleeding.	Higher risk of bleeding, infection, neurological damage.

Post-treatment care and monitoring

Following treatment, your doctor will provide instructions for post-treatment care and monitor your recovery. This may include:

Wound Care: For drainage sites, instructions on keeping the area clean and dry to prevent infection.
Medication: Prescription of pain relief or antibiotics, especially if infection is a risk.
Physical Therapy: Rehabilitation may be recommended for hematomas that affected joints or muscles.
Follow-Up Imaging: Subsequent scans may be necessary to ensure the hematoma is resolving properly.

For more information on when to seek medical care, resources like the Cleveland Clinic's detailed explanation on hematomas can be very helpful.

When a doctor's care is critical

While most minor hematomas are not cause for alarm, certain symptoms should prompt immediate medical attention. These include hematomas that continue to grow in size, are accompanied by severe pain, or show signs of infection such as increased redness, warmth, or pus. Furthermore, any signs of a serious intracranial hematoma, such as a severe headache, confusion, blurred vision, or weakness on one side of the body, require emergency care.

Frequently Asked Questions

A hematoma is a larger, more significant collection of blood that pools in tissues after a blood vessel ruptures. While a bruise also results from bleeding, it involves smaller blood vessels and doesn't typically create the same pressure or swelling as a hematoma.

The decision to drain a hematoma depends on its size, location, and impact on the patient. Doctors will consider drainage if the hematoma is large, painful, not resolving on its own, or if there's a risk of infection or pressure on surrounding tissues.

While minor hematomas can be monitored, you should see a doctor if the swelling is severe, continues to grow, is accompanied by a severe headache or confusion, or doesn't improve with RICE within two weeks.

Yes, a hematoma can become a breeding ground for bacteria, leading to infection, especially if it's large or has been drained improperly. A doctor may prescribe antibiotics if an infection is suspected.

RICE stands for Rest, Ice, Compression, and Elevation. This method helps to manage minor hematomas by reducing swelling, decreasing pain, and preventing further bleeding, allowing the body to naturally reabsorb the pooled blood.

Healing time varies greatly depending on the hematoma's size, location, and the treatment method. Small hematomas may resolve in a couple of weeks with conservative care, while large or surgically treated hematomas can take much longer.

The most serious hematomas are often intracranial (within the skull), such as subdural or epidural hematomas, because they can cause pressure on the brain. Other serious types can occur in the chest or abdomen, leading to significant internal bleeding.