In their simplest, most basic forms, hematomas are simply bruises. The prefix "hema," in fact, means blood. You get a hematoma when blood vessels break. Breaking of blood vessels causes blood to leak out and gather at the surface of your skin. You are probably looking at pooled blood when you see black and blue marks on your skin.
A Bruise Marks The Spot
When a blood vessel breaks or tears, blood leaks out and forms a hematoma -- a localized collection of blood. Superficial bruises are the most common form of hematomas. When you bump into the furniture or something hits you, the trauma breaks tiny blood vessels in your skin. The blood that subsequently leaks into your skin causes a superficial hematoma -- also known as a contusion or simply a black-and-blue mark. The size of the bruise is primarily dependent on the area and force of the impact.
Ice Might Help
The media is rife with images of people holding a steak to their black eye. There's actually some scientific rationale behind this dramatic portrayal -- using a cold compress, not necessarily a steak. Applying something cold immediately to the sight of a superficial injury might limit the size and extent of a developing bruise. Cold temperature causes the blood vessels in the area to constrict, which can help stop the bleeding into the skin more quickly. You need to apply a cold compress as soon as possible to have much affect on a developing black-and-blue mark. Even if you miss the window to limit bruising, a cold pack can still help limit pain by dulling the nerves in the area.
Beware of Other Symptoms
Everyday bruises are typically harmless and gradually go away, passing through an array of colors as your body mops up the leaked blood. A bruise caused by a high-energy impact that comes up quickly, however, might indicate a more significant injury. For example, there might be an underlying bone fracture or muscle damage. These more serious injuries can lead to rapid swelling that might obstruct the blood supply to the injured area. This complication -- acute compartment syndrome -- requires immediate medical care. Signs and symptoms to look for if you've suffered a significant blow include:
-- rapid swelling of the area
-- distorted shape of the injured area
-- inability to move the affected area normally
-- extreme or worsening pain
-- numbness or tingling
Unexplained Bruises Require Attention
Everyone has had the experience of noticing a bruise and not recalling how it happened. It's normal for that to occur occasionally. But if you notice frequent or multiple bruises with no apparent explanation, it's a good idea to schedule a visit with your doctor. Unexplained bruising may be due to something as simple as frequent use of over-the-counter pain relievers such as aspirin or ibuprofen (Advil, Motrin). But in some cases, easy bruising might indicate something more serious, such as a bleeding disorder, leukemia or another form of cancer. While there's no need to panic over unexplained bruising, it's not something you should ignore.
Hematomas You Can't See Are The Most Dangerous
Superficial hematomas are far more common, but internal hematomas also occur and are usually much more serious. For example, a hematoma in or around the brain can be life-threatening. These bleeds typically occur due to a fall, injury or accident -- although the traumatic event may initially seem relatively minor. As the hematoma grows, however, it puts pressure on the brain. This pressure is often compounded by brain swelling related to the injury. Pressure on the brain can lead to dangerous effects, possibly even death, if not relieved quickly. Signs and symptoms to watch for that might indicate a hematoma in or around the brain include:
-- worsening headache
-- nausea and vomiting
-- unusual drowsiness
-- confusion, mental slowness or slurred speech
-- sudden numbness, tingling or inability to move part of the body
Reviewed by: Tina M. St. John, M.D.