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.
Symptoms may include a persistent headache, drowsiness, confusion, memory changes, paralysis on the opposite side of the body, speech or language impairment, and other symptoms depending on which area of the brain is damaged. Some hematomas don't need to be removed because they're small and produce no signs or symptoms. But because signs and symptoms may appear or worsen days or weeks after the injury, if you don't have surgery, you may have to be watched for neurological changes, have your intracranial pressure monitored and undergo repeated head CT scans.
Medical therapy of intracranial hemorrhage is principally focused on adjunctive measures to minimize injury and to stabilize individuals in the perioperative phase. Recent clinical trial data suggests that treatment with recombinant factor VIIa (rFVIIa) within 4 hours after the onset of intracerebral hemorrhage limits the growth of the hematoma, reduces mortality, and improves functional outcomes at 90 days. However, further study of this medication in a broader cohort did not result in improved clinical outcomes. This intervention may also result in a small increase in the frequency of thromboembolic adverse events. The early use of rFVIIa in patients with head injury without systemic coagulopathy may reduce the occurrence of enlargement of contusions, the requirement of further operation, and adverse outcome.