The hematoma is as abnormal collection of blood outside of a blood vessel. It can happen because the wall of capillary, vein, artery or blood vessel wall has been damaged and the blood has leaked into the tissues where it does not belong. The hematoma can be tiny and it can just have a dot of blood. Also it can be large and it cause significant swelling. The blood vessels in our bodies are under constant repair. Minor injuries are happening all the time and the body is usually able to repair the damaged vessel wall by activating the blood clotting cascade and forming fibrin patches. If the damage is extensive and the large defect allows for continuous bleeding, then the repair fails. If there is a great pressure within the blood vessel, for example the major artery, then the blood will continue to leak through the damaged wall and the hematoma will expand. The blood which escapes from within the blood vessel is very irritating to the surrounding tissue and it can cause symptoms of inflammation, such as redness, swelling and pain. The symptoms of hematoma vary a lot and they depend on their size, location and if they are associated with edema or swelling. Hematomas can happen in every part of the body. No matter how the hematoma is described or where it is located, it remains a collection of clotted blood outside a blood vessel.
You should know that the symptoms of hematoma depend on the size and location. The most common symptoms of hematoma are disfiguring bruises, redness, swelling and pain. Here are some symptoms specific to the location of hematoma:
- Splenic, hepatic or peritoneal hematoma symptoms: flank pain and abdominal pain
- Subungual hematoma symptoms: disfiguring nails, nail loss, nail weakness, nail pain
- Epidural hematoma symptoms: back pain, weakness, loss of bowel or bladder control
- The subdural hematoma can have some of the following confusion, headache, neurologic problems (weakness on one side, difficulty speaking, falling), seizures
There are some cases when there are not any symptoms even if the person has a very large hematoma. If the bleeding happens to be inside the abdominal cavity, then it can expand to a very large size before it causes any symptoms. This can occur because the hematoma can spread in a relatively free space and it is not pressing on any organs to cause pain or some other symptoms. But on the other hand, when someone has a small hematoma under the nail, then it can cause a lot of pain because the blood expands into a very tight space under the nail bed and this is causing irritation and inflammation of the nearby nail and skin which is resulting in swelling and pain. Sometimes a mass or lump can be felt which depends on the location of hematoma.
An injury or trauma to blood vessels is the most common cause for hematoma. It can happen as a result of any damage to the blood vessel which can disrupt the integrity of the blood vessel wall. Also there are some cases when a minimal damage to a small blood vessel can lead to hematoma. The hematoma under the nail (it is also called subungual hematoma) can happen from minor trauma to the nail or from a light stroke against an object. Major hematomas are caused by more severe traumas. If you fall from a height or you get into a motor vehicle accident, then this can cause a large bleeding under your skin or inside your body cavities (your chest or abdomen). There are other types of tissue injuries which are causing hematoma and they can result from surgeries of any kind, injection of medications (for example, insulin, blood thinners, vaccines) and invasive medical or dental procedure (for example, biopsies, incision and drainage, cardiac catheterization). These procedures can damage the nearby tissues and blood vessels and this is a reason why hematomas often form around the site of the procedure. There are rare cases when the hematoma can happen spontaneously without any identifiable cause or recollection of any specific trauma or injury. People who take medications, such as aspirin – containing products, Persanthine, aspirin, Plavix and Coumadin can develop a hematoma much easier and with less severe injury to their blood vessel than other people.