Everything to Know About Hematoma: Types, Causes, and More
The majority of hematomas go away on their own without medical treatment. However, in some cases, you may require surgery.
Read on to learn about the types of hematomas and what causes them. This guide also discusses symptoms, treatments, when to contact a doctor, and more.
A hematoma occurs following injury to a blood vessel. This causes blood to pool or collect outside of the vessel.
Possible causes or risk factors for hematomas include:
- bone fractures, which can result in tearing or leaking from surrounding blood vessels
- anticoagulation medications, such as warfarin
- arterial puncture
Surgery can also cause damage to blood vessels. This in turn can lead to a hematoma.
There are different types of hematoma. These include:
- subcutaneous hematoma
- intramuscular hematoma
- subungual hematoma
- auricular hematoma
- nasal septal hematoma
- abdominal hematoma
- pelvic hematoma
- subchorionic hematoma
- intracranial hematoma
“Subcutaneous” means beneath the skin. A subcutaneous hematoma is one that occurs underneath the skin.
Muscular hematomas occur when blood from vessels pools in the muscle groups. Muscular hematomas most commonly occur in the abdominal waist.
Subungual hematomas occur beneath the fingernail or toenail. The usual cause is injury to the finger or toe, which results in discoloration as blood collects beneath the nail.
An auricular hematoma affects the ear. It occurs when blood collects underneath the perichondrium, which is connective tissue in the ear. Auricular hematoma is the cause of “cauliflower ear.”
Nasal septal hematoma
Nasal septal hematomas occur when blood collects beneath the mucous membranes of the nasal septum cartilage and bone. A nasal septal hematoma is a rare but serious complication of facial injury.
Abdominal hematomas can occur in the abdominal cavity or in the muscles or tissues of the abdominal wall.
Specifically, a rectus sheath hematoma is a result of bleeding in the rectus abdominis and pyramidalis muscles inside the sheath.
Pelvic hematomas occur from damage to the pelvic organs. Bleeding from a pelvic fracture can be fatal.
Subchorionic hematomas occur beneath the chorion membranes. The chorion membranes enclose the embryo inside the uterus.
Intracranial hematomas occur inside the skull or brain. There are four main types of intracranial hemorrhage or hematoma.
- Epidural hematoma: This occurs between the dura mater, the outer layer of the membranes surrounding the brain, and the skull. Skull fracture causes 85–95% of cases.
- Subdural hematoma: This occurs underneath the dura mater. Subdural hematoma can occur spontaneously or result from head trauma, coagulopathy, or a rupture in the veins. Learn more about subdural hematoma.
- Subarachnoid hemorrhage: This occurs on the pia mater meningeal layer that covers the surface of the brain beneath the arachnoid layer of the meninges. Subarachnoid hemorrhage most commonly occurs after trauma to the cortical surface vessels.
- Intracerebral or intraparenchymal hemorrhage: This is a blood pocket in the brain tissue itself. It most commonly occurs as a result of high blood pressure causing damage to cerebral blood vessels.
View the slideshow below for hematoma pictures.
This shows hematoma on the leg.
Giada Canu/Stocksy United
This shows hematoma on the cheek.
This shows subungual hematoma beneath the fingernail.
Callaleo, CC BY-SA 4.0, via Wikimedia Commons
This shows subungual hematoma beneath the toenail.
A hematoma occurs when there is damage to a blood vessel, causing blood to collect outside of the vessel.
A bruise is bleeding under the skin. Following an injury, superficial blood vessels break, causing the bleeding. If the skin does not break, blood remains inside. This causes the discoloration of a bruise.
Find out more about the difference between hematomas and bruises.
Broken blood vessels cause both hematoma and hemorrhage.
Hematoma refers to blood that pools outside of the blood vessel. Hemorrhage involves acute blood loss. A hematoma can occur as a result of hemorrhaging.
Learn about cerebral hemorrhage, a type of bleeding in the brain.
Symptoms of a hematoma depend on the location and severity of the injury, and include:
- skin discoloration
- seizure, with a subdural hematoma
- loss of bowel or bladder control, with an epidural hematoma
- abdominal pain, if the hematoma affects your peritoneum, liver, or spleen
- lethargy or confusion, with an intracranial hematoma
Symptoms such as swelling and bleeding may develop slowly.
Contact your doctor if you have symptoms of a hematoma. While hematomas are not always a cause for concern, there may be damage to deeper tissues and blood vessels.
Find out more about symptoms of internal bleeding.
Most hematomas are small and may heal on their own. Bleeding may stop spontaneously and may not require treatment.
Your doctor may also advise that you stop taking anticoagulation medication. However, continue to take any prescription medications unless your doctor recommends that you stop or change them.
In severe cases, such as a significant intracranial hematoma, surgery is usually necessary. Possible procedures include:
- trephination, to reduce pressure
- arterial embolization, blocking the blood supply to the affected area
- incision and drainage or needle aspiration, to drain the blood
- burr hole surgery, drilling a small hole into the skull to help with draining
Before surgery, your doctor and surgeon will discuss options and risks of the procedure with you.
Contact your doctor as soon as you have concerns about hematoma.
A hematoma can go away on its own. However, it is important to know if there is damage to deep tissues or blood vessels.
You should also contact your doctor if bleeding does not stop or if the area causes you pain.
To help with a diagnosis, your doctor may ask you questions such as:
- When did you first notice the hematoma?
- Do you know what caused the hematoma?
- Have you had a previous hematoma?
- Do you have a history of blood clotting problems?
- Do you have other symptoms?
- Are you taking blood thinning medication?
In some cases, your doctor may be able to diagnose hematoma with a physical examination. However, they may order tests to confirm the diagnosis.
Depending on the cause or location of the hematoma, tests may include:
- CT scan
- multidetector computed tomography for suspected spontaneous muscular hematoma
- CT angiogram
- X-ray to check for broken bones
- CT or MRI scan to check for abscesses or foreign bodies
- complete blood count to check for thrombocytopenia, low platelet count
- coagulation studies to test for coagulopathy
A number of factors increase your risk of developing a hematoma, including:
- contact sports, such as wrestling and boxing
- aneurysms, which can rupture and cause a hematoma
- anticoagulation medications
- bleeding disorders, such as hemophilia
- heavy alcohol use
Complications depend on location and severity, and include:
- myositis ossificans, formation of cartilage or bone inside muscle
- abscess formation from infection of undrained blood
- blood reaccumulation after drainage
- saddle nose deformity as a result of nasal septal hematoma
- nervous system damage in cases of intracranial hematoma
- infarct, tissue death resulting from obstructed blood flow
- vasospasm, constriction of blood vessels in the brain that reduces blood flow
- brain herniation
Complications of a hematoma can be serious and lead to death. Contact your doctor as soon as you have concerns about hematoma to reduce your risk of complications.
Here are questions people also ask about hematoma.
Is a hematoma serious?
Hematomas can be serious. While many can heal on their own, hematomas such as those affecting the brain require immediate medical attention.
How long does a hematoma take to heal?
Healing time will vary depending on the individual and the type of hematoma. For example, subdural hematoma may take several weeks or months to heal. Pain from subungual hematoma may resolve within days. Your doctor will be able to advise you about expected recovery times for a specific hematoma.
A hematoma occurs when a blood vessel ruptures and blood collects in the area. This can happen anywhere in the body.
Many hematomas heal without medical treatment, but some require surgery. Contact your doctor as soon as you experience symptoms of a hematoma.
A hematoma can be serious if it occurs in the skull cavity or involves deep tissues. Surgery is possible to drain the blood and reduce the risk of complications.