Hematoma definition
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Hematoma Definition and Clinical Implications
General Definition of Hematoma
A hematoma is broadly defined as a collection of blood outside of blood vessels, typically resulting from an injury to the wall of a blood vessel, which allows blood to seep into surrounding tissues . This can occur due to trauma, surgical procedures, or spontaneous events without an identifiable cause. Hematomas can form in various parts of the body, including under the skin, within muscles, or in internal organs.
Types and Locations of Hematomas
Subcutaneous Hematomas
Subcutaneous hematomas are collections of blood beneath the skin, often associated with sutured lacerations or surgical incisions. They can also result from blunt trauma or tearing of muscles, tendons, or ligaments. These hematomas typically present with focal swelling, taut skin, and discomfort, and may or may not show overlying discoloration, complicating diagnosis.
Intracranial Hematomas
Intracranial hematomas occur within the skull and can be associated with penetrating brain injuries. These hematomas are classified based on their location, such as subcortical, intracerebral, or intraventricular, and are often identified through direct visualization during surgery. Intracranial hematomas can result from laceration of blood vessels by a penetrating object, leading to significant clinical implications.
Post-Traumatic Hematomas
Post-traumatic hematomas are common following injuries and can vary in size and severity. They are typically self-limiting and may not require extensive treatment, although severe cases can lead to complications such as infection, necrosis, or wound dehiscence . Conservative management is often sufficient, but prompt recognition and intervention are crucial to prevent adverse outcomes .
Clinical Management and Complications
Postoperative Hematomas
In the postoperative setting, hematomas can lead to significant complications, including infection, wound dehiscence, and scarring. Early recognition and appropriate management, such as negative-pressure wound therapy and external fixation, are essential to mitigate these risks.
Hematoma Expansion in Intracerebral Hemorrhage
Hematoma expansion (HE) is a critical factor in intracerebral hemorrhage (ICH) and is a predictor of poor outcomes. Various definitions of HE exist, with absolute growth cutoffs being more predictive of severe outcomes compared to relative cutoffs. Understanding and accurately defining HE is important for clinical trials and patient management in ICH.
Conclusion
Hematomas are collections of blood outside blood vessels, resulting from various causes such as trauma, surgery, or spontaneous events. They can occur in different body parts, each with specific clinical implications and management strategies. Early recognition and appropriate intervention are crucial to prevent complications and ensure optimal patient outcomes.
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