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The decision depends on the size, cause and location of the bleed and other factors. General lack of awareness. In general, symptoms of brain bleeds can include: Sudden tingling, weakness, numbness, or paralysis of the face, arm or leg, particularly on one side of the body. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Traumatic-Brain-Injury-Hope-Through. Time between the start of symptoms and start of a bleed and between start of a bleed and confirmation of a bleed are critical time points. [1] When compared to younger patients, elderly patients with traumatic head . Bed rest, medications and observation may be all that is needed. These injuries affect brain function, usually for a brief period, resulting in signs and symptoms of concussion. Brain tumor that presses on brain tissue causing bleeding. Symptoms of concussion include brief: loss of consciousness after the head injury; periods of memory . An intracranial hematoma is a collection of blood within the skull. Mayo Clinic is a not-for-profit organization. Advertising revenue supports our not-for-profit mission. Olympia RB, et al. Milder bleeds or contusions to the brain can still cause many residual side effects after initial recovery from the injury. Conditions related to pregnancy or childbirth, including. Third Party materials included herein protected under copyright law. A traumatic brain injury (TBI) occurs when a traumatic event causes harm to the brain. Symptoms can last for days, weeks or even longer. Dizziness, loss of balance, difficulty walking. This pressure can lead to breathing problems, paralysis and death if not treated. Violently shaking of the head and upper body also can cause concussions. If you have a subdural hematoma, blood is leaking out of a torn vessel into a space below the dura mater, a membrane between the brain and the skull. Your healthcare providers may order regular imaging tests (such as an MRI) to monitor the hematoma and make sure it is healing. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Guide to Raising a Healthy Child. Bleeding in the brain raises the finding to more than concussion. Watch neuroscientist David Linden explain how some nerve cells can repair themselves. During the examination, the doctor obtains a complete medical history of the patient and family and asks how the injury occurred. Diffuse Axonal Injury (DAI) Diffuse axonal injuries are one of the most severe types of traumatic brain injury. British Journal of Sports Medicine. The neurology exam will include blood pressure checks, vision testing, balance and strength testing, as well as reflex tests and a memory check. Because the blood must clot to stop the bleeding a bruise results from, contusions also increase cardiovascular risks. Current Pain and Headache Reports. For a long time, scientists thought that brain and spinal cord cells, once damaged, could not be fixed. (See next question.). Additional surgery may be needed to remove large or thick blood clots if present. Trauma to the head can cause neurological problems and may require further medical follow up. Long- or short-term changes in personality or behavior may also occur. Inability to move part of the body (paralysis). An acute subdural hematoma is an emergency situation and has an 80 percent mortality rate. Evans RW. When the swelling has gone down and there is little chance of more swelling, the device will be removed. Memory loss, disorientation, and personality changes, especially in older adults with chronic subdural hematoma. More severe TBI symptoms last longer, involve a deep loss of consciousness, and may result in memory loss. Two types of brain bleeds can occur inside the brain tissue itself intracerebral hemorrhage (also called cerebral hemorrhage and hemorrhagic stroke) and intraventicular hemorrhage. A head injury is the most common cause of bleeding within the skull. Allscripts EPSi. One of the main concerns with a concussion is the development of a brain hemorrhage. 2016; https://www.mdedge.com/familymedicine/article/110762/neurology/sport-related-concussion-how-best-help-young-athletes. Use of this website and any information contained herein is governed by the Healthgrades User Agreement. Archives of Physical Medicine and Rehabilitation. A concussion refers to more widespread brain trauma from a blow to the head or swift shaking. The three types of subdural hematomas are: All three types require medical attention as soon as signs and symptoms appear so that permanent brain damage can be prevented. Bump on the head: When is it a serious head injury? Accessed Nov. 22, 2019. Bydon M (expert opinion). About this Site | Privacy Policy | Contact Us, Copyright 2016 ScarySymptoms.com | All Rights Reserved |. Yes. Collins MW, et al. These layers cover and protect the brain. The Neurological Institute is a leader in treating and researching the most complex neurological disorders and advancing innovations in neurology. Update on the epidemiology of concussion/mild traumatic brain injury. Neurosurgery. It's a type of bleed that occurs within your skull but outside the actual brain tissue. Weakness or numbness in any part of the body. These include aspirin, ibuprofen (Advil), and naproxen . Once brain cells die, they do not regenerate. 2019; doi:10.1136/bjsports-2017-097981. Chick embryos received 25% ethanol (75 L) and TSE (250, 500, 750 &mu . Concussion. Without treatment, large hematomas can lead to coma and death. You might seem fine after a head injury. When a brain hemorrhage occurs, oxygen may no longer be able to reach the brain tissue supplied by these leaky or burst vessels. https://www.uptodate.com/contents/search. If worrisome signs develop later, seek emergency care. Remember though, if you suspect a brain bleed, the sooner you can get to the emergency room the better your chance of survival. Nov. 27, 2019. Draining the blood relieves the pressure the blood buildup causes on the brain. In-depth explanations you wont find on other sites. Patients with this type of fracture frequently have bruises around their eyes and a bruise behind their ear. Experts also recommend that adult, child and adolescent athletes with concussions not return to play on the same day as the injury. These are fractures that occur along the suture lines in the skull. Brain bleeds can occur within the meninges, which is the area inside the skull but outside the actual brain tissue. Other names for subdural hematoma are subdural hemorrhage or intracranial hematoma. A subdural hematoma is a type of bleed inside your head. They should still see their healthcare provider for evaluation. A head injury may result from motor vehicle or bicycle accidents, falls, assaults, and sports injuries. The person suffering the "concussion" is usually not in a position . Giza CC, et al. A contusion is a bruise of the brain tissue involving bleeding and swelling in the brain. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Other times, a small, hollow device (bolt) is placed through the skull into the space just between the skull and the brain. The most common cause of an epidural hematoma is trauma. Of note, there was an increase in ductular reaction with PMNs in the DBD group (52.9%, p-value = 0.041). McBride W. Subdural hematoma in adults: Management and prognosis. Percent of People with Normal Head CT Who Develop Brain Bleed. When bicycling, motorcycling, snowboarding or engaging in any recreational activity that may result in head injury, wear protective headgear. Nutrients and fluids as needed. Clinical evidence indicates diabetes as a majorrisk factor for titaniumimplant treatment with high failure rates and poor osteointegration, but the underlying mechanism involved remains elusive.We hypothesize that reactive oxygen species (ROS) overproduction may contribute to the impaired osteogenesis of porous titanium implants (pTi) under diabetic conditions. If we combine this information with your protected When trauma is not the cause, the most common causes are long-standing, high blood pressure in older adults, bleeding disorders in either children or adults, or the use of medications that cause blood thinning or certain illicit drugs. It's cushioned from everyday jolts and bumps by cerebrospinal fluid inside your skull. In adults, normal blood pressure means you have readings below 120/80. Other complications include: Although it may not be possible to prevent a hematoma as a result of an accident, you can reduce your risk by: If you have a subdural hematoma, your prognosis depends on your age, the severity of your head injury and how quickly you received treatment. Straightforward information on fitness, exercise and fat loss. 2019; doi:10.1123/jsr.2017-0217. information and will only use or disclose that information as set forth in our notice of All Rights Reserved. These bleeds can "squish the brain," Graffagnino said, and cause injury at a slower rate. Meehan WP, et al. Healthcare providers treat larger hematomas with decompression surgery. Stage 1 high blood pressure (a diagnosis of hypertension) is now between 130 and 139 systolic or between 80 and 89 diastolic (the bottom number). Concussion symptoms usually are temporary and include a brief change in mental status. The risk of subdural hematoma increases as you age. Although they do not appear that often, an expanding bleed in the brain can be life threatening. To provide you with the most relevant and helpful information, and understand which Diseases can cause spontaneous leakage of blood into the brain. The symptoms of a head injury may resemble other problems or medical conditions. Inability to read, write, speak, or effectively communicate. In: Ferri's Clinical Advisor 2022. There are several types of ICH, or blood clots, in or around the brain. What is a concussion? If a stroke has occurred, the cause (bleeding or blood clot) must be determined so that the appropriate treatment can be started. It's important for athletes never to return to sports while they're still experiencing signs and symptoms of concussion. Symptoms include ongoing headache, confusion and drowsiness, nausea and vomiting, slurred speech and changes in vision. This site complies with the HONcode standard for trustworthy health information: verify here. . https://www.uptodate.com/contents/search. Concussion in children: Management. Clinical Journal of Sports Medicine. Symptoms of a brain hemorrhage depend on the area of the brain involved. (Headache is usually severe in the case of acute subdural hematoma.). Driscoll SW (expert opinion). The following are some of the different types of head injuries: Concussion. Head injuries are also commonly referred to as brain injury, or traumatic brain injury (TBI), depending on the extent of the head trauma. Conditions related to abnormal collagen formation in the blood vessel walls that can cause to walls to be weak, resulting in a rupture of the vessel wall. Alcohol liver disease (ALD) is one of the leading outcomes of acute and chronic liver injury. Accessed Jan. 9, 2020. https://www.uptodate.com/contents/search. A traumatic brain injury (TBI) is defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force. And even if you feel fine, ask someone to watch out for you. Privacy Policy|Advertising Policy|Privacy Preferences Center|Do Not Sell My Personal Information. Your healthcare provider will ask you about your head injury (when and how it occurred, review your symptoms and other medical problems, review medications you are taking and ask about other lifestyle habits). Since the brain cannot store oxygen, it relies upon a series of blood vessels to supply oxygen and nutrients. Concussion (child). This content does not have an Arabic version. Head injuries are one of the most common causes of disability and death in adults. the unsubscribe link in the e-mail. Most people usually recover fully after a concussion. Blood then leaks between the dura mater and the skull to form a mass that presses on brain tissue. Accessed Nov. 22, 2019. Make a donation. Usually, healthcare providers leave a drain in place for several days following surgery to allow the blood to continue draining. The result: bruises, broken blood vessels, or nerve damage to the brain. Grade 1: The least severe form of concussion, when the individual's brain functions return to normalcy after 15 minutes. Bleeding (hemorrhage) may require immediate decompression of the brain to release pooled blood and relieve pressure. Long-term rehabilitation treatment may include: Steps you can take to reduce your risk include: Besides depriving the brain of oxygen and killing brain cells, bleeding inside the brain also prevents nerve cells from communicating with the parts of the body and the functions they control. Inside your skull and over the brain there are 3 layers called the meninges. Neurological diagnostic tests and procedures. Voss JD, et al. Symptoms include ongoing headache, confusion and drowsiness, nausea and vomiting, slurred speech and changes in vision. Learn how doctors diagnose TBI vs. concussion and how treatments differ for each. Intracranial hematoma (ICH). Subdural Hematoma. Rehabilitation and recovery time vary according to each persons unique brain bleed and the extent of rehabilitation possible. Primary brain injury refers to the sudden and profound injury to the brain that is considered to be more or less complete at the time of impact. There are three categories of hematoma subdural hematoma, epidural hematoma and intracerebral (intraparenchymal) hematoma. 2015; doi:10.1007/s11916-015-0506-z. Scarysymptoms.com will not be liable for damages arising out of or in connection with the use of this site. information is beneficial, we may combine your email and website usage information with This type of brain injury may lead to bleeding in or around your brain, causing symptoms . Symptoms may include: Raised, swollen area from a bump or a bruise, Small, superficial (shallow) cut in the scalp, Problems with memory and/or concentration. Recovery from concussion. Concussions are usually caused by a blow to the head. Children and adolescents should be evaluated by a health care professional trained in evaluating and managing pediatric concussions. Unfortunately, some patients who remain in a coma, or have been severely paralyzed after an intracranial or cerebral hemorrhage may need permanent, long-term care typically provided in a nursing home. Copyright 2023 Healthgrades Marketplace, LLC, Patent US Nos. After impact, the brain may undergo a delayed trauma - it swells - pushing itself against the skull and reducing the blood flow. A leak from abnormally formed connections between arteries and veins (. Schultz BA (expert opinion). May 18, 2022. Anti-anxiety drugs and/or medication to manage blood pressure. OBJECTIVES: To systematically review the effects of UCBCs on brain outcomes in animal models of . Changes in vision. include protected health information. However, if the hematoma is severe, the buildup of blood can cause pressure on the brain. We are vaccinating all eligible patients. Summary of evidence-based guideline update: Evaluation and management of concussion in sports: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Concussion refers to cases of loss of awareness following head injury, whereas cerebral contusion refers specifically to bruising in the brain. The purpose of the meninges is to cover and protect the brain. Chronic subdural hematoma in patients under 40, 3 chronic SDH questions answered by neurosurgeon. Subdural hematomas occur when a blood clot forms underneath the skull and underneath the dura, but outside of the brain. When there is a direct blow to the head, shaking of the child (as seen in many cases of child abuse), or a whiplash-type injury (as seen in motor vehicle accidents), the bruising of the brain and the damage to the internal tissue and blood vessels is due to a mechanism called coup-countrecoup. Difficulty speaking or understanding spoken or written words. Trauma is a leading cause of morbidity and mortality among older patients. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. 2019; doi:10.1016/j.apmr.2019.10.179. A head injury is a broad term that describes a vast array of injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the head. Scary Symptoms assumes no responsibility for ad content, promises made, or the quality or reliability of the goods or services offered in any advertisement. Focal and diffuse brain injury are ways to classify brain injury: focal injury occurs in a specific location, while diffuse injury occurs over a more widespread area.It is common for both focal and diffuse damage to occur as a result of the same event; many traumatic brain injuries have aspects of both focal and diffuse injury. Sometimes, people forget because they are disoriented. Depending on the type, location and extent of the brain bleed, many patients do not survive the initial bleeding event. Traumatic Brain Injury (TBI) Pre-Class Notes TBI: external force causing damage to the brain o Mechanical (physical), thermal, chemical, electrical, and radiation Major cause of preventable death and disability in the US Force= Mass x Acceleration o Force- depends on object size and the speed o Impact is dependent on the amount of force, direction, duration, rate, and more Mechanisms of Injury . Bleeding that occurs inside the brain itself (also called intraparenchymal hemorrhage) can sometimes occur spontaneously. Accessed Nov. 22, 2019. this is known as a coup/contra-coup injury. Change in level of consciousness or alertness, lack of energy, sleepiness or coma. These fractures are more often seen in newborns and older infants. Sudden acceleration or deceleration of the head, caused by events such as a car crash or being violently shaken, also can cause brain injury. Mayo Clinic. Rarely, experiencing a second concussion before signs and symptoms of a first concussion have resolved may result in rapid and usually fatal brain swelling. Dec. 17, 2019. Remember to always visit an emergency care center immediately after any major head injury, and tell them if you're experiencing any of the following: Headache. To most people, a brain bleed simply means any bleed inside your head. They develop symptoms days later. It is important to get to a hospital emergency room immediately to determine the cause of the bleeding and to begin medical treatment. Mayo Clinic; 2018. numbness or weakness in part of their body. [1][2] Sometimes . These doctors further describe brain bleeds by their exact location. Not likely: Concussion is often associated with micro bleeds in the brain that do not produce a mass or reach the csf. Neurology. Signs and symptoms of a subdural hematoma include: As bleeding continues and the pressure in the brain increases, symptoms can get worse. bleeding from their ears or bruising behind their ears. Dont hesitate. It is illegal to copy, reprint or republish any content or portions of content from this site without the author's permission. Primary injuries can involve a specific lobe of the brain or can involve the entire brain. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). If you have a subdural hematoma, you have experienced a tear in a blood vessel, most commonly a vein, and blood is leaking out of the torn vessel into the space below the dura mater membrane layer. Because a subdural hematoma is a type of traumatic brain injury (TBI), they share many symptoms. In this type of fracture, the normal suture lines are widened. 2013; doi: 10.1212/WNL.0b013e31828d57dd. As the brain twists, the cerebral tissue slides back and forth until the long connecting fibers in the brain (called axons) tear. The brain can be hurt in many different ways; injuries to the brain are typically classified . See your healthcare provider if you have a head injury. The full extent of the problem may not be completely understood immediately after the injury, but may be revealed with a comprehensive medical evaluation and diagnostic testing. The older person may not remember hitting their head. In patients with anaplastic oligodendroglial tumors with 1p/19q codeletion, probable 20-year overall survival following radiotherapy without vs with the combination of procarbazine, lomustine, and vincristine was 13.6% vs 37.1% (80 patients; HR, 0.60 [95% CI, 0.35-1.03]; P = .06) in the EORTC 26951 trial and 14.9% vs 37% in the RTOG 9402 trial . Younger people are far more likely to sustain an acute subdural hematoma typically from vehicular crashes and sport-related impact (skiing, boxing, football). Side effects from decompression surgery include an increased risk of bleeding, infection and blood clots. The Neurological Institute is a leader in treating and researching the most complex neurological disorders and advancing innovations in neurology. Findings In this cohort study, subarachnoid hemorrhage, subdural hematoma, and contusion often co-occurred and were associated with both incomplete recovery and more severe impairment out to 12 months after injury, while intraventricular and/or petechial hemorrhage co-occurred and were associated with more severe impairment up to 12 months . https://www.uptodate.com/contents/search. Meehan WP, et al. If you or someone you know has any of the following symptoms after a head injury, call 911 or seek medical attention immediately. The injury can be as mild as a bump, bruise (contusion), or cut on the head, or can be moderate to severe in nature due to a concussion, deep cut or open wound, fractured skull bone(s), or from internal bleeding and damage to the brain. Enlarged head in babies, whose soft skulls can enlarge as blood collects. Mayo Clinic does not endorse companies or products. http://www.cdc.gov/headsup/basics/concussion_whatis.html. The amnesia usually involves forgetting the event that caused the concussion. Brain injury from even the mildest concussion can have short-term and long-term effects. At Another Johns Hopkins Member Hospital: Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov. Accessed Nov. 22, 2019. A surgeon drills one or more holes in the skull to drain the blood. Older adults have an increased risk of developing another bleed (hemorrhage) after recovering from a chronic subdural hematoma. Pooling of blood from an intracranial hemorrhage or cerebral hemorrhage also puts pressure on the brain and deprives it of oxygen. Accessed Jan. 9, 2020. Centers for Disease Control and Prevention. Cerebral contusions are scattered areas of bleeding on the surface of the brain, most commonly along the undersurface and poles of the frontal and temporal lobes. Dec. 26, 2019. Bleeding in the brain, namely a subdural hematoma, can result from getting hit in the head or hitting your head in a fall. Silverberg ND, et al. Prediction of Chronic Subdural Hematoma: Symptoms After Fall? Symptoms can last for days, weeks or longer. Hemorrhagic strokes make up about 13 % of stroke cases. They are sometimes, but not always, associated with a skull fracture. Temporary loss of consciousness (though this doesn't always occur), Forgetfulness, such as repeatedly asking the same question, Irritability and other personality changes, Psychological adjustment problems and depression, You or your child experiences a head injury, even if emergency care isn't required, A loss of consciousness lasting longer than 30 seconds, Fluid or blood draining from the nose or ears, Vision or eye disturbances, such as pupils that are bigger than normal (dilated pupils) or pupils of unequal sizes, Appearing very pale for longer than an hour, Confusion or disorientation, such as difficulty recognizing people or places, Slurred speech or other changes in speech, Obvious difficulty with mental function or physical coordination, Changes in physical coordination, such as stumbling or clumsiness, Large head bumps or bruises on areas other than the forehead in children, especially in infants under 12 months of age, Falling, especially in young children and older adults, Participating in a high-risk sport, such as football, hockey, soccer, rugby, boxing or other contact sport, Participating in high-risk sports without proper safety equipment and supervision, Being involved in a motor vehicle collision, Being involved in a pedestrian or bicycle accident. Epidural hematomas are usually associated with a skull fracture. 3,4. In some cases, conventional angiography may be done to identify an. Advertising on our site helps support our mission. Both devices are inserted by thedoctor either in the intensive care unit (ICU) or in the operating room. These people include: Subdural hematomas can be life-threatening. https://www.uptodate/contents/search. Loss of consciousness. Anti-epileptic drugs for seizure management. These affects can include: However, over time and with a lot of effort and determination in rehabilitation (physical, occupational and speech therapy), you can regain some of these lost functions. Scary Symptoms does not make any representation regarding the accuracy of any information contained in those advertisements or sites, and does not accept any responsibility or liability for the content of those advertisements and sites and the offerings made by the third parties. The diagnosis of a head injury is made with a physical examination and diagnostic tests. https://www.cdc.gov/traumaticbraininjury/prevention.html. Special note about head injury and symptoms in seniors: Some of the symptoms of subdural hematoma in older people, like memory loss, confusion, and personality changes, could be mistaken for dementia. Accessed Nov. 24, 2019. TBI can also cause serious long term effects (like physical . A hemorrhagic stroke . The leaking blood forms a hematoma that presses on the brain tissue. Memory loss after a blow to your head can make you forget about the blow. Persons who suffer a severe brain injury may lose muscle strength, fine motor skills, speech, vision, hearing, or taste function, depending on the brain region involved and the severityof brain damage. Journal of Sport Rehabilitation. Your doctor may perform a physical and neurologic exam along . During the first 24 hours you should avoid medications that can increase risk of bleeding. Usually, no interventions are necessary. Blood clot that formed in the brain or traveled to the brain from another part of the body, which damaged the artery and caused it to leak. Common symptoms after a concussive traumatic brain injury are headache, loss of memory (amnesia) and confusion. Drowsiness and progressive loss of consciousness, Loss of movement (paralysis) on the opposite side of the body from the head injury, Experience vomiting, weakness, blurred vision, unsteadiness, Take aspirin or other blood-thinning medication daily. Brain swelling after a concussion has the potential to amplify the severity of the injury. Help Millions of people find the right doctor and care they need, Get immediate care and visit with providers from the comfort of your home, or anywhere, Urgent care centers can be faster and cheaper for situations that are not life threatening, Doctors and patients discuss the latest medical treatments and health tips, Search prescription drugs for why theyre used, side effects and more, Back and Neck Surgery (Except Spinal Fusion). Some types of TBI can cause temporary or short-term problems with normal brain function, including problems with how the person . Changing lifestyle habits to reduce risk of another hemorrhage. The extent of the person's recovery depends on the type of brain injury and other medical problems that may be present. These bruises may occur without other types of bleeding or they . Head injury may cause the brain to swell. A hematoma that gets bigger can cause gradual loss of consciousness and possibly death. raumatic Brain and Spinal Cord Fatalities Among High School and College Football Players United States, 20052014. After more serious head injuries are excluded, a diagnosis of concussion can be made. Lempke L, et al. A concussion is a type of mild traumatic brain injury. Last reviewed by a Cleveland Clinic medical professional on 05/04/2020. Centers for Disease Control and Prevention. Secondary injury is resulted by the subsequent pathophysiological changes and the complex interaction between them. 5 Gym Exercises that Can Cause Snapping Hip Syndrome, The 5 Worst Weight Exercises if You Have a Bad AC Joint, How to Stop Fingers from Hurting After Deadlift Workouts, Middle Back Soreness from Sustained Dead Hanging. Can jumping exercises cause chronic subdural hematoma? Mayo Clinic. A brain bleed causes brain damage and yes, they can be life-threatening. Merck Manual Professional Version. Mild TBI, which is typically defined by Glasgow Coma Scale score 13, accounts for the vast majority of all TBIs, particularly in the setting of sports-related injuries. Decompression may be done through a burr hole procedure (drilling a hole in the skull to allow blood drainage), a craniectomy incision (partial removal of the skull to allow the swelling brain to expand), or a craniotomy (opening of the skull cavity).