Managing Persistent Head Hematomas: When to Seek Neurosurgery Help

Head hematoma

When I was a child, I hit the back of my left head and lost consciousness for a few seconds before waking up.
My head then swelled up! At that time, I didn't see a doctor and just waited for it to heal.
Who would have thought that the lump is still there now, with a hard and uneven shape.
When I look in the mirror, I notice that the area is red and has less hair.
I would like to ask which specialty I should consult if I want to address this hematoma.
Additionally, since it has been several years, will the hospital doctors be willing to treat it? Although it no longer hurts, I psychologically do not want the hematoma to remain.
If it is a subcutaneous hematoma, what methods are typically used to remove it? Thank you, doctor, for taking the time to read this!

UZI, 20~29 year old female. Ask Date: 2018/06/23

Dr. Zhang Junwei reply Neurosurgery

Blood clots do not last that long; it is likely tissue proliferation.
Please consult a physician for further evaluation.

Reply Date: 2018/06/23

More Info

When dealing with persistent head hematomas, especially those that have been present for several years, it is crucial to approach the situation with careful consideration of both medical and psychological factors. In your case, the history of a childhood injury that resulted in a hard, irregular lump on the back of your head raises several important points regarding management and treatment options.

First and foremost, it is essential to determine the nature of the hematoma. Given that it has been present for years and is now hard and irregular, it may have evolved into a chronic subdural hematoma or a calcified hematoma. These types of hematomas can sometimes become asymptomatic, meaning they do not cause pain or other neurological symptoms, but they can still be a source of concern for patients due to their appearance and the potential for complications.

If you are considering treatment to remove the hematoma, the appropriate specialist to consult would be a neurosurgeon. Neurosurgeons are trained to handle conditions involving the brain and surrounding structures, including hematomas. During your consultation, the neurosurgeon will likely perform a thorough evaluation, which may include imaging studies such as a CT scan or MRI to assess the size, location, and characteristics of the hematoma. This information is crucial for determining the best course of action.

In terms of treatment options, if the hematoma is indeed a chronic subdural hematoma, surgical intervention may be warranted. The most common surgical procedure for this condition is a craniotomy, where a section of the skull is removed to access the hematoma, allowing for its evacuation. In some cases, a less invasive approach, such as a burr hole drainage, may be considered, depending on the size and location of the hematoma.

If the hematoma is determined to be a simple subcutaneous hematoma (a bruise under the skin), treatment may involve less invasive methods. In such cases, options may include aspiration (removing the fluid with a needle) or surgical excision if the hematoma is large or causing cosmetic concerns. However, it is important to note that if the hematoma has been stable and asymptomatic for years, the risks associated with surgery may outweigh the benefits.

In addition to the physical aspects of treatment, it is also important to address the psychological impact of having a visible lump on your head. Many patients experience anxiety or distress related to the appearance of a hematoma, even if it is not causing any physical symptoms. Discussing these feelings with your healthcare provider can help you explore options for managing any psychological discomfort you may be experiencing.

In summary, if you are looking to have the hematoma evaluated and potentially treated, the first step is to schedule an appointment with a neurosurgeon. They will be able to assess your condition, discuss the risks and benefits of surgical intervention, and help you make an informed decision about your treatment options. Remember that while the physical removal of the hematoma may alleviate some concerns, it is also important to consider the emotional and psychological aspects of living with a long-standing injury.

Similar Q&A

Chronic Brain Hemorrhage: Understanding Delayed Diagnosis and Treatment Options

Hello Dr. Zhang, my father (born in 1943) had a severe head injury from a fall down the stairs at the end of August, resulting in significant bleeding that required emergency care. A CT scan at that time showed only minor intracranial bleeding, so the emergency physician sutured ...

Dr. Zhang Junwei reply Neurosurgery
Without detailed CT scans and neurological examinations, it is not possible to determine an accurate treatment plan. It is recommended to bring the discharge summary and CT scans to an outpatient appointment for discussion with the physician.

Managing Subdural Hematoma in Patients with Liver Disease: A Complex Case

Hello Dr. Ding, The patient is diagnosed with liver cancer, cirrhosis, thrombocytopenia, splenomegaly, and a subdural hematoma. Last year, the patient was found to have a subdural hematoma due to altered mental status and underwent a splenectomy, which was unsuccessful. Current...

Dr. Ding Xianwei reply Neurosurgery
Dear You: This situation can be divided into two parts. The first is the issue of headaches. If the subdural hematoma has been present for a long time and the CT scan shows that the hematoma is no longer visible, then this is a matter of sequelae, and only symptomatic treatment c...

Understanding Chronic Subdural Hematoma and Epilepsy After Brain Injury

The patient previously sustained injuries from a car accident, resulting in delayed intracranial hemorrhage, which the physician has diagnosed as chronic subdural hematoma. The patient has been hospitalized and has been on antiepileptic medication for nearly six months. An MRI ex...

Dr. Cai Zongzhang reply Neurology
Hello Mr. Li: Brain hemorrhage often has epilepsy as a sequela. The duration of medication depends on the frequency of seizures. Whether chronic subdural hematoma requires surgical treatment also depends on the symptoms. It is recommended to visit a neurosurgery outpatient clinic...

Managing Hydrocephalus After Prolonged Coma: Surgical Options Explored

In late November last year, the patient was involved in a car accident, suffering a head injury from a rear-end collision, resulting in a coma and dilated pupils. After surgery to remove a portion of the left skull and to relieve intracranial hemorrhage, the patient has remained ...

Dr. Zhang Junwei reply Neurosurgery
Due to the lack of detailed medical history, it is not possible to determine whether it would be beneficial for the patient's recovery, as I am concerned about providing you with incorrect information.