Hematoma causes
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Causes of Hematoma: An Overview
Trauma-Induced Hematoma
Trauma as a Primary Cause
Hematomas are frequently caused by trauma, which leads to the extravasation of blood into surrounding tissues, forming a palpable mass. This is often seen in cases of blunt force injuries, surgical complications, or even minor incidents such as hair combing in children . Traumatic events can cause various types of hematomas, including subdural, epidural, and intraparenchymal hematomas, depending on the location and severity of the injury.
Systemic and Medical Conditions
Anticoagulant Therapy and Vascular Malformations
Anticoagulant therapy is a significant risk factor for hematomas, particularly spinal hematomas. These can occur spontaneously or in conjunction with spinal and epidural anesthetic procedures. The combination of anticoagulant therapy and increased pressure in the vertebral venous plexus can lead to spontaneous spinal hematomas. Additionally, vascular malformations are another common cause, often requiring surgical intervention for resolution.
Liver Disease and Diabetes
Certain medical conditions, such as liver disease and poorly controlled diabetes, can predispose individuals to hematoma formation. These conditions can exacerbate the risk of hematoma enlargement, particularly in cases of intracerebral hemorrhage. High systolic blood pressure and elevated fasting plasma glucose levels are critical factors that increase the likelihood of hematoma growth.
Spontaneous Hematomas
Idiopathic and Spontaneous Cases
In some instances, hematomas can occur without any identifiable cause, known as idiopathic hematomas. These are particularly challenging to diagnose and manage due to the lack of a clear etiology. Spontaneous hematomas can also result from systemic conditions like bacterial endocarditis, which can lead to septic emboli and subsequent subdural hematomas.
Rare and Unusual Causes
Pseudoaneurysms and Central Venous Catheters
Rare causes of hematomas include ruptured traumatic pseudoaneurysms of arteries, such as the middle meningeal artery, which can lead to significant intracerebral hemorrhage. Another unusual cause is the extravascular infusion through a dislocated central venous catheter, which can result in life-threatening mediastinal hematomas.
Conclusion
Hematomas can arise from a variety of causes, ranging from common traumatic injuries to rare medical conditions and spontaneous events. Understanding the underlying causes is crucial for timely diagnosis and effective management. Whether due to trauma, systemic diseases, or idiopathic factors, recognizing the signs and risk factors associated with hematomas can significantly improve patient outcomes.
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