Cranial hematoma symptoms

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Symptoms of Cranial Hematoma: A Comprehensive Overview

Introduction to Cranial Hematoma Symptoms

Cranial hematomas, which are collections of blood within the skull, can present with a variety of symptoms depending on their location, size, and the underlying cause. Understanding these symptoms is crucial for timely diagnosis and treatment.

Common Symptoms of Cranial Hematomas

Headache and Neurological Deficits

Headache is a prevalent symptom in patients with cranial hematomas. It can vary in intensity and may be accompanied by other neurological deficits. For instance, a case of idiopathic hypertrophic cranial pachymeningitis misdiagnosed as an acute subdural hematoma presented with a headache following head trauma, which later progressed to cranial nerve palsies and eye inflammation. Similarly, patients with intracranial hematomas following neuraxial block often report headaches, which can be mistaken for postdural puncture headaches (PDPH).

Sensorimotor Deficits

Sensorimotor deficits, including numbness and weakness, are also common. In a study of lumbosacral subdural hematoma associated with cranial subdural hematoma, patients presented with bilateral radiating leg pain and sensorimotor deficits. Another case reported mild paraparesis and numbness in both lower extremities due to simultaneous cranial and spinal subdural hematomas.

Altered Consciousness

Altered consciousness can be a severe symptom of cranial hematomas. For example, a patient with a traumatic subacute spinal subdural hematoma followed by a symptomatic cranial subdural hematoma experienced a significant drop in consciousness, necessitating urgent surgical intervention.

Seizures and Postictal States

Seizures can be a symptom of cranial hematomas, particularly in cases where the hematoma follows trauma incurred during a seizure. Symptoms such as status epilepticus, focal seizures, or postictal neurological deficits should raise suspicion of an expanding hematoma.

Non-Postural Headache and Vomiting

Non-postural headache and vomiting are warning signs of intracranial subdural hematoma, especially following spinal or epidural anesthesia. A headache lasting more than five days, with or without neurological signs, should prompt urgent cranial imaging to rule out hematoma.

Specific Cases and Their Symptoms

Chronic Subdural Hematoma

Chronic subdural hematomas can present with slowly progressing neurological symptoms. In a systematic review of calcified or ossified chronic subdural hematomas, patients exhibited a range of symptoms from acute onset to long-term neurological deficits, often following head trauma or cranial surgery.

Epidural Hematoma in Sickle Cell Disease

Patients with sickle cell disease may develop cranial epidural hematomas, which are rare but serious. These patients can experience complications such as stroke and neuropsychological deficits, making the diagnosis of hematoma challenging.

Conclusion

Cranial hematomas present with a variety of symptoms, including headaches, sensorimotor deficits, altered consciousness, seizures, and non-postural headaches. Recognizing these symptoms is essential for prompt diagnosis and treatment, which can significantly improve patient outcomes. Understanding the diverse presentations of cranial hematomas can aid healthcare providers in making timely and accurate diagnoses.