Hematoma

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Haematoma
Other nameshaematoma
Upper Arm Bruise.jpg
Contusion (bruise), a simple form of hematoma.
Specialty Emergency medicine

A hematoma, also spelled haematoma, is a localized bleeding outside of blood vessels, due to either disease or trauma including injury or surgery [1] and may involve blood continuing to seep from broken capillaries. A hematoma is benign and is initially in liquid form spread among the tissues including in sacs between tissues where it may coagulate and solidify before blood is reabsorbed into blood vessels. An ecchymosis is a hematoma of the skin larger than 10mm. [2]

Contents

They may occur among/within many areas such as skin and other organs, connective tissues, bone, joints and muscle.

A collection of blood (or even a hemorrhage) may be aggravated by anticoagulant medication (blood thinner). Blood seepage and collection of blood may occur if heparin is given via an intramuscular route; to avoid this, heparin must be given intravenously or subcutaneously.

It is not to be confused with hemangioma, which is an abnormal buildup/growth of blood vessels in the skin or internal organs. [3]

Signs and symptoms

Some hematomas are visible under the surface of the skin (commonly called bruises) or possibly felt as masses/lumps. Lumps may be caused by the limitation of the blood to a sac, subcutaneous or intramuscular tissue space isolated by fascial planes. This is a key anatomical feature that helps prevent injuries from causing massive blood loss. In most cases the hematoma such as a sac of blood eventually dissolves; however, in some cases they may continue to grow such as due to blood seepage or show no change. If the sac of blood does not disappear, then it may need to be surgically cleaned out/repaired.

The slow process of reabsorption of hematomas can allow the broken down blood cells and hemoglobin pigment to move in the connective tissue. For example, a patient who injures the base of his thumb might cause a hematoma, which will slowly move all through the finger within a week. Gravity is the main determinant of this process.

Hematomas on articulations can reduce mobility of a member and present roughly the same symptoms as a fracture.

In most cases, movement and exercise of the affected muscle is the best way to introduce the collection back into the blood stream.

A misdiagnosis of a hematoma in the vertebra can sometimes occur; this is correctly called a hemangioma (buildup of cells) or a benign tumor.

Classification

Types

Intramuscular hematoma at buttocks as a result of a sports injury. Hematoma at backside.jpg
Intramuscular hematoma at buttocks as a result of a sports injury.
L to R: Epidural Hematoma, Subdural Hematoma, and Intracranial Hematoma. Types of Hematoma.jpg
L to R: Epidural Hematoma, Subdural Hematoma, and Intracranial Hematoma.

Degrees

Etymology

The English word "haematoma" came into use in 1826. The word derives from the Greek αἷμα haima "blood" and -ωμα -oma, a suffix forming nouns indicating a mass or tumor. [5]

See also

Related Research Articles

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Otorhinolaryngology is a surgical subspecialty within medicine that deals with the surgical and medical management of conditions in the head and neck. Doctors who specialize in this area are called otolaryngologists, head and neck surgeons, or ENT surgeons. Patients seek treatment from an otorhinolaryngologist for diseases of the ear, nose, throat, base of the skull, head, and neck which encompasses the surgical management and reconstruction of cancers and benign tumors of the head and neck as well as plastic surgery of the face and neck.

Intramuscular injection injection of a substance directly into a muscle

Intramuscular injection, often abbreviated IM, is the injection of a substance directly into muscle. In medicine, it is one of several methods for parenteral administration of medications. Muscles have larger and more numerous blood vessels than subcutaneous tissue; intramuscular injections usually have faster rates of absorption than subcutaneous or intradermal injections. The volume of injection is limited to 2-5 milliliters, depending on injection site.

Meninges Membranes that envelop the brain and spinal cord

The meninges are the three membranes that envelop the brain and spinal cord. In mammals, the meninges are the dura mater, the arachnoid mater, and the pia mater. Cerebrospinal fluid is located in the subarachnoid space between the arachnoid mater and the pia mater. The primary function of the meninges is to protect the central nervous system.

Pia mater Delicate innermost layer of the meninges, the membranes surrounding the brain and spinal cord

Pia mater, often referred to as simply the pia, is the delicate innermost layer of the meninges, the membranes surrounding the brain and spinal cord. Pia mater is medieval Latin meaning "tender mother". The other two meningeal membranes are the dura mater and the arachnoid mater. Both the pia and arachnoid mater are derivatives of the neural crest while the dura is derived from embryonic mesoderm. The pia mater is a thin fibrous tissue that is permeable to water and small solutes. The pia mater allows blood vessels to pass through and nourish the brain. The perivascular space between blood vessels and pia mater is proposed to be part of a pseudolymphatic system for the brain. When the pia mater becomes irritated and inflamed the result is meningitis.

Dura mater Thick membrane surrounding the brain and spinal cord

Dura mater is a thick membrane made of dense irregular connective tissue that surrounds the brain and spinal cord. It is the outermost of the three layers of membrane called the meninges that protect the central nervous system. The other two meningeal layers are the arachnoid mater and the pia mater. The dura surrounds the brain and the spinal cord and is responsible for keeping in the cerebrospinal fluid. It is derived primarily from the neural crest cell population, with postnatal contributions of the paraxial mesoderm.

Bruise Type of hematoma

A bruise, also known as a contusion or ecchymosis, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasate into the surrounding interstitial tissues. Most bruises are not very deep under the skin so that the bleeding causes a visible discoloration. The bruise then remains visible until the blood is either absorbed by tissues or cleared by immune system action. Bruises, which do not blanch under pressure, can involve capillaries at the level of skin, subcutaneous tissue, muscle, or bone. Bruises are not to be confused with other similar-looking lesions. These lesions include petechia, purpura, The term ecchymosis is synonymous.

Subdural hematoma Hematoma usually associated with traumatic brain injury

A subdural hematoma (SDH) is a type of bleeding in which a collection of blood—usually associated with a traumatic brain injury—gathers between the inner layer of the dura mater and the arachnoid mater of the meninges surrounding the brain. It usually results from tears in bridging veins that cross the subdural space.

Intracranial hemorrhage hemorrhage, or bleeding, within the skull

Intracranial hemorrhage (ICH), also known as intracranial bleed, is bleeding within the skull. Subtypes are intracerebral bleeds, subarachnoid bleeds, epidural bleeds, and subdural bleeds.

Epidural space

Dura mater is the outermost meningeal layer that covers the brain and spinal cord. It consists of two layers; the inner meningeal layer and the outer periosteal layer. The potential space between the layers of the dura mater is called the epidural space. The epidural space exists around both the brain and the spinal cord.

Epidural hematoma Build-up of blood between the dura mater and skull, usually caused by injury

Epidural hematoma is when bleeding occurs between the tough outer membrane covering the brain and the skull. Often there is loss of consciousness following a head injury, a brief regaining of consciousness, and then loss of consciousness again. Other symptoms may include headache, confusion, vomiting, and an inability to move parts of the body. Complications may include seizures.

Middle meningeal artery

The middle meningeal artery is typically the third branch of the first portion of the maxillary artery, one of the two terminal branches of the external carotid artery. After branching off the maxillary artery in the infratemporal fossa, it runs through the foramen spinosum to supply the dura mater the outer meningeal layer, and the calvaria. The middle meningeal artery is the largest of the three (paired) arteries that supply the meninges, the others being the anterior meningeal artery and the posterior meningeal artery.

Rectus abdominis muscle paired muscle running vertically on each side of the anterior wall of the human (of some other mammals) abdomen

The rectus abdominis muscle, also known as the "abdominal muscle" or "abs", is a paired muscle running vertically on each side of the anterior wall of the human abdomen, as well as that of some other mammals. There are two parallel muscles, separated by a midline band of connective tissue called the linea alba. It extends from the pubic symphysis, pubic crest and pubic tubercle inferiorly, to the xiphoid process and costal cartilages of ribs V to VII superiorly. The proximal attachments are the pubic crest and the pubic symphysis. It attaches distally at the costal cartilages of ribs 5-7 and the xiphoid process of the sternum.

Subdural space Potential space between the arachnoid and dura maters

The subdural space is a potential space that can be opened by the separation of the arachnoid mater from the dura mater as the result of trauma, pathologic process, or the absence of cerebrospinal fluid as seen in a cadaver. In the cadaver, due to the absence of cerebrospinal fluid in the subarachnoid space, the arachnoid mater falls away from the dura mater. It may also be the site of trauma, such as a subdural hematoma, causing abnormal separation of dura and arachnoid mater. Hence, the subdural space is referred to as "potential" or "artificial" space.

Raccoon eyes

Raccoon eyes or periorbital ecchymosis is a sign of basal skull fracture or subgaleal hematoma, a craniotomy that ruptured the meninges, or (rarely) certain cancers. Bilateral hemorrhage occurs when damage at the time of a facial fracture tears the meninges and causes the venous sinuses to bleed into the arachnoid villi and the cranial sinuses. In lay terms, blood from skull fracture seeps into the soft tissue around the eyes. Raccoon eyes may be accompanied by Battle's sign, an ecchymosis behind the ear. These signs may be the only sign of a skull fracture, as it may not show on an X-ray. They may not appear until up to two hours after the injury. It is recommended that the patient not blow their nose, cough vigorously, or strain to prevent further tearing of the meninges.

Lymphangioma Malformations of the lymphatic system characterized by lesions that are thin-walled cysts

Lymphangiomas are malformations of the lymphatic system characterized by lesions that are thin-walled cysts; these cysts can be macroscopic, as in a cystic hygroma, or microscopic. The lymphatic system is the network of vessels responsible for returning to the venous system excess fluid from tissues as well as the lymph nodes that filter this fluid for signs of pathogens. These malformations can occur at any age and may involve any part of the body, but 90% occur in children less than 2 years of age and involve the head and neck. These malformations are either congenital or acquired. Congenital lymphangiomas are often associated with chromosomal abnormalities such as Turner syndrome, although they can also exist in isolation. Lymphangiomas are commonly diagnosed before birth using fetal ultrasonography. Acquired lymphangiomas may result from trauma, inflammation, or lymphatic obstruction.

Subgaleal hemorrhage

Subgaleal hemorrhage or hematoma is bleeding in the potential space between the skull periosteum and the scalp galea aponeurosis.

Dural venous sinuses Venous channels in the dura mater

The dural venous sinuses are venous channels found between the endosteal and meningeal layers of dura mater in the brain. They receive blood from the cerebral veins, receive cerebrospinal fluid (CSF) from the subarachnoid space via arachnoid granulations, and mainly empty into the internal jugular vein.

Vascular tumor Wikipedia disambiguation page

A vascular tumor is a tumor of vascular origin; a soft tissue growth that can be either benign or malignant, formed from blood vessels or lymph vessels. Examples of vascular tumors include hemangiomas, lymphangiomas, hemangioendotheliomas, Kaposi's sarcomas, angiosarcomas, and hemangioblastomas. An angioma refers to any type of benign vascular tumor.

Scalp reconstruction is a surgical procedure for people with scalp defects. Scalp defects may be partial or full thickness and can be congenital or acquired. Because not all layers of the scalp are elastic and the scalp has a convex shape, the use of primary closure is limited. Sometimes the easiest way of closing the wound may not be the ideal or best way. The choice for a reconstruction depends on multiple factors, such as the defect itself, the patient characteristics and surgeon preference.

Pediatric stroke

Pediatric stroke is a stroke that happens in children or adolescents. Stroke affects about 6 in 100,000 children. Stroke is a leading cause of death in children in the U.S.

References

  1. "Hematoma, toenail, gross". library.med.utah.edu. 2013. Retrieved January 18, 2013.
  2. "Information on Hematoma Types, Causes, and Treatments on". Emedicinehealth.com. Retrieved 2013-04-11.
  3. "Hemangioma". U.S. National Library of Medicine. 2016-04-05. Retrieved 2016-04-19.
  4. Robbins basic pathology. Kumar, Vinay, 1944-, Abbas, Abul K.,, Aster, Jon C.,, Perkins, James A. (10th ed.). Philadelphia, Pennsylvania. 2017-03-28. p. 101. ISBN   9780323353175. OCLC   960844656.CS1 maint: others (link)
  5. "hematoma". Online Etymology Dictionary.
Classification
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