Intracranial hematomas are accumulations of blood within the brain or between the brain and the skull. An intracranial hematoma may occur because the fluid that surrounds your brain can't absorb the force of a sudden blow or a quick stop. The cause of intracranial bleeding (hemorrhage) usually is a head injury, often resulting from automobile, motorcycle or bicycle accidents, falls, assaults, and sports injuries.
Blood-thinning medication, such as warfarin used but the treatment may need supportive therapy to reverse the effects of the medication and reduce the risk of further bleeding. Options for reversing blood thinners include administering vitamin K and fresh frozen plasma. Hematoma treatment often requires surgery. The 15 case series of surgery for PICH involving a total of 1524 patients (654 treated surgically) are potentially confounded and the results inconclusive. The pooled results of the three randomized controlled trials of open craniotomy and one trial of endoscopic evacuation for supratentorial PICH in a total of 349 patients (173 treated surgically) indicate a nonsignificant increase in odds of death and dependency at 6 months for patients treated surgically (odds ratio, 1.23; 95% confidence interval, 0.77 to 1.98). The odds of death or dependency at 6 months were 2.1 (1.1 to 4.1) for patients undergoing craniotomy and 0.45 (0.2 to 1.0) for endoscopic evacuation.