Hematoma Formation: An In-Depth Look

Shivendra Pratap Singh


High Court Lucknow

Medico Legal

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Published on: 12 Aug, 2023

A hematoma refers to a collection of blood outside of blood vessels, typically resulting from blood vessel damage. It can occur almost anywhere in the body. Hematomas are a common consequence of trauma, but other causes, including medical procedures or diseases that affect blood coagulation, can also lead to their formation. This article delves into the types, causes, symptoms, treatment, and potential complications of hematomas.

1. Types of Hematoma:

  • Subdural Hematoma: Occurs between the dura mater (outermost layer) and the arachnoid mater (middle layer) of the brain’s protective coverings. It’s often due to head injury.
  • Epidural Hematoma: Located between the dura mater and the skull. Typically arises from trauma, especially associated with skull fractures.
  • Subarachnoid Hematoma: Blood accumulates in the subarachnoid space, where cerebrospinal fluid typically circulates around the brain and spinal cord.
  • Intracerebral Hematoma: Refers to blood collection directly within the brain tissue, often resulting from traumatic brain injury or stroke.
  • Contusion or Bruise: A mild type of hematoma in which small blood vessels under the skin are damaged, leading to discoloration.
  • Subungual Hematoma: Found under a nail after a crushing injury to a finger or toe.

2. Causes of Hematoma Formation:

  • Trauma: The most common cause. Injuries can rupture blood vessels, leading to blood accumulation in the adjacent tissues.
  • Surgery: Surgical procedures can inadvertently damage blood vessels, causing a hematoma.
  • Blood Disorders: Conditions like hemophilia or certain medications (e.g., anticoagulants) can predispose individuals to hematomas since they affect the blood’s ability to clot.
  • Disease or Infection: Some infections or tumors can erode blood vessels, leading to hematomas.

3. Symptoms and Presentation:

  • Pain: Hematomas can cause pain due to the pressure they exert on surrounding tissues.
  • Swelling and Inflammation: The affected area often becomes swollen and inflamed.
  • Discoloration: As the blood begins to clot and heal, it often changes color, moving from deep blue/purple to green and yellow over time.
  • Neurological Symptoms: If occurring near or within the brain, hematomas can lead to symptoms like confusion, dizziness, loss of consciousness, or even seizures.

4. Treatment:

  • Minor Hematomas: These often resolve on their own. Applying cold immediately after the injury can reduce swelling, while heat can help dissipate the pooled blood as the hematoma heals.
  • Medication: Over-the-counter painkillers can alleviate pain. If a hematoma is related to anticoagulant medication, adjusting the dosage or switching medications might be necessary.
  • Surgery: In cases where the hematoma is compressing vital structures, such as in the brain, surgical drainage or removal might be necessary.

5. Potential Complications:

  • Compression: Hematomas can exert pressure on nearby structures, potentially causing damage.
  • Infection: If a hematoma is associated with a penetrating wound, there’s a risk of bacterial contamination leading to infection.
  • Calcification: Over time, a hematoma may calcify, leading to a hardened lump.


Hematomas are a relatively common medical occurrence, resulting from a variety of causes. Their significance and the need for treatment largely depend on their size, location, and the overall health of the individual. Proper medical evaluation and treatment, when necessary, can prevent potential complications and expedite healing.


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