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Bruise (hematoma)

A bruise can happen quickly: once not paying attention, bumped against the edge of the table or door and the bruised area of ​​skin turns reddish-blue. This is where the colloquial name "blue spot" comes from.

In medicine, a bruise is called a hematoma. By definition, it is an injury to one or more blood vessels. This causes blood to accumulate in soft tissues or in cavities in the body. A bruise can also be accompanied by pain and swelling. The deeper this pool of blood is beneath the surface of the skin, the less noticeable the symptoms are.

Most doctors name bruises after the place where they formed. Some examples:

  • Hemarthrosis (Greek: arthros = joint) is a bruise in the joint.
  • Hemothorax (Greek: thorax = breast) refers to a hematoma in the chest area.
  • A monocle or eyeglass hematoma is a ring-shaped bruise around the eyes. It can indicate a fractured skull.
  • In the case of bleeding in the head, for example as a result of a head injury, doctors also differentiate between different types: intracerebral hematoma (within the brain tissue), subdural hematoma (between the hard meninges and the brain) or epidural hematomas (between the hard meninges and cranial bones)

How does a hematoma develop?

The causes of the bruise are usually a fall while exercising, a blow during scuffles or a knock on the edge of the table, in which mechanical forces act on the tissue. This can cause blood vessels to rupture. The blood emerges from the vessels and flows into the surrounding tissue or into body cavities.

Some people bruise more easily than others. With them, a slight mechanical action on the tissue and the vessels bursting is sufficient. Some even get a bruise from scratching the skin. Incidentally, women are more prone to bruising than men because they have fewer collagen fibers that protect the blood vessels. Older people are also more prone to bruising because their vessels are less stable and the collagen network becomes more permeable.

Sometimes, however, a bruise occurs without any external influence or an apparent reason. If, for example, blood coagulation is inhibited, be it due to a congenital bleeding disorder or the use of medication with the active ingredients acetylsalicylic acid (e.g. aspirin) or phenprocoumon (e.g. Marcourmar), bruising can occur more quickly than usual.

In addition, if the syringe needle accidentally injures blood vessels, a bruise after blood draw or vaccination can occur. A bruise after surgery is usually the result of bleeding after surgery.

Is a bruise dangerous?

Usually bruises are harmless. They usually go away on their own after two to three weeks. However, there are some cases when a professional should look at the bruise. For example, when you should see a doctor:

  • if the bruise is around the eyes or near joints
  • if there are severe bruises on the head or in the genital area
  • if the bruise is migrating, very large, or has occurred for no apparent reason
  • if you have an encapsulated bruise. It is not necessarily dangerous. However, bruises can sit deep in muscle tissue and harden. Sometimes hematomas also form in places where it is difficult for the body to break them down. They remain in the tissue, cause pain or impair the function of muscles and joints.
  • At the latest when the bruise is still not gone after two months