Intracranial Hematoma

Head injuries account for approximately 70% of traumatic accident deaths. Intracranial hematoma plays an important role in the death and disability that are associated with head injury. Intracranial hematoma is a serious and possibly a life threatening condition that often requires immediate medical attention. Many patients with intracranial hematoma harbor mass lesions that require emergency decompression. Other causes include brain tumors, liver disease, autoimmune syndromes and bleeding disorders.

The human brain floats within the skull. It is surrounded by cerebrospinal fluid which cushions the brain from the bounces of everyday movements. Sometimes it becomes impossible for the fluid to absorb the force of a sudden blow or a quick stop. Under such situations, the brain may slide forcefully against the inner wall of the skull and get bruised. An intracranial hematoma occurs when the blood vessel ruptures between the skull and the brain. The blood leaks between the brain and the skull. This collection of blood, hematoma, which is possibly clotted, compresses the brain tissue. Some hematomas require surgery to remove the blood clot whereas some others can be treated without surgery.

Symptoms of intracranial hematoma include headache, nausea, vomiting, lethargy and slurred speech. The pupils may appear of unequal size. Memory loss is often associated with head trauma. One may even forget that they have suffered a blow. These symptoms of intracranial hematoma may occur either immediately or several weeks or months after a blow has been received in the head.

Injury in the head is the most common cause of intracranial hematoma. Among elderly persons, even a mild head trauma is more likely to cause a hematoma in the brain. Hematoma resulting from injury in the head is classified as:

Subdural hematoma: This occurs when the blood vessels, most often the veins rupture between the brain and the dura mater which is the outermost of three membrane layers that covers the brain. The blood that leaks forms a hematoma. This compresses the brain tissue. The danger here is that if the hematoma keeps growing then there is a progressive decline in consciousness and possible death. The risk of subdural hematoma is greater in people who use aspirin or other anticoagulants regularly. Alcoholics and very young and very old people also stand to be affected by subdural hematoma. All types of subdural hematomas require medical attention as soon as the symptoms become apparent. Other wise permanent brain damage may be the result.

Epidural hematoma: This type of hematoma occurs when the blood vessel, usually the artery, ruptures between the surface of the dura mater and the skull. Morbidity and mortality from epidural hematoma is substantial unless immediate medical attention is given. The cause of epidural hematoma is most of the time road automobile accidents or any other traumatic injuries.

Intraparenchymal hematoma: When blood pools in the white matter of the brain, Intraparenchymal hematoma occurs. There may be multiple severe Intraparenchymal hematomas after a head trauma. Serious brain damage can occur, as the neurons can no longer communicate. A physician may find it difficult to diagnose intracranial hematoma, as it may not be immediately apparent. It is better to seek medical advice after any significant blow has been received to the head and if the patient has lost consciousness or experiences symptoms such as headache, lethargy, nausea and vomiting. A CT scan or MRI scan is suggested to define the position and size of a hematoma.

After a head injury, doctors use medications such as corticosteroids and diuretics to control the edema in the brain after head injury. Often surgery is required. If the blood clot is localized and there is no excessive clotting, then perforation is made through the skull and the liquid is removed by suction. Large hematomas require opening of a section of the skull to remove blood clots. It is essential to wear appropriate safety equipment and gadgets during sports, including helmet when riding, motorcycling, horseback riding, skating or doing any other activity that may result in injury to head. Chances of motor vehicle accidents can be minimized by wearing a seat belt.

AFP Test

AFP Test or Alpha-fetoprotein test is conducted on pregnant women to check the AFP level in the blood. The liver in the fetus produces AFP naturally. Determining the amount of AFP in the mother's blood will help identify any neural tube defect in the fetus. Neural tube defects arise in 2 out of every 1,000 pregnancies. AFP test also helps check for Down's syndrome. There are 60% chances for detecting Down's syndrome when the AFP levels are low in the blood. AFP can also be calculated from the sample of amniotic fluid of a pregnant woman. This screening test is generally performed between 16 and 18 weeks of pregnancy and is very sensitive between 15 and 17 weeks. The accuracy of the AFP test result lies in the exact age of the fetus. The AFT test is also referred to as maternal serum alpha-fetoprotein (MSAFP). AFP test is done on men and non-pregnant women too to confirm cancer in the testicles, stomach, pancreas, liver and the ovaries. High levels of AFP can indicate renal cell cancer.

Interpretation of AFP test results: In men and non-pregnant women, the values of the AFP test is 0-6.4 IU/mL (international units per milliliter), 0-20 nanograms per milliliter (ng/mL) or 0-20 micrograms per liter. In pregnant women of about 15 - 22 weeks gestation, the AFP results usually show 19-75 IU/mL, 7-124 ng/mL or 7-124 microgram per liter. AFP test values vary depending on the weight of the woman and race. Black women have higher values than white women and white women have higher values than Asian women. High AFP can suggest multiple pregnancies, fetus with neural tube defects, and abdominal wall defect in the fetus or fetal death. In non-pregnant adults, high AFP values mean cancer in the testicles or ovaries. High AFP can also indicate liver disease and bowel inflammation.

MCV blood test

MCV (Mean Corpuscular Volume) blood test. This blood test measures the size of RBC. Any change in the size of RBCs indicates certain disorders. This test is often conducted along with RDW blood test. With MCV blood test, RBCs can be categorized into normal, small or large sizes. Larger cells are usually indicative of macrocytic anemia. On the other hnad, those with small cells may sufer microcytic anemia. Larger RBCs may indicate liver disease, hypothyroidism, folic acid or vitamin B12 deficiency or marrow aplasia. Decreased size of red blood cells is usually noticed in persons suffering from anemia, thalassemia, lead poisoning or chronic renal failure.