Is a Contusion Serious?

A contusion is a bruise that can result from an impact or similar injury when a small vessel in the area gets damaged. A contusion may be serious when it's accompanied by dizziness, headache, confusion, and other symptoms.

When a person suffers from some type of injury, many conditions can result. A contusion is a bruise that can result from an impact or similar injury when a small vessel in the area gets damaged. 

A contusion is another word for a bruise. It is a discoloration of the skin or tissue from an injury. The medical term is ecchymosis.

A contusion occurs when blood vessels under the skin leak after physical damage is suffered. When blood begins to pool under the skin, it causes a blue, black, brown, purple, or yellow discoloration. 

There are several classifications of bruise:

• Hematoma: These usually occur from trauma like a major fall or accident. They are marked by a collection of blood outside of the blood vessels that is painful and swollen. They can cause severe skin and tissue damage.
• Purpura: This consists of small bleeding under the skin.
• Senile purpura: This occurs due to aging and the drying and thinning of the skin. The skin bruises more easily.
• Petechiae: These are pinpoint lesions less than 2 mm in size, reddish in color. They will not turn white after the application of pressure.
• Black eye: Occurs from a blow to the head. Fluids, including blood, pool under the eye. This forms a discolored ring around the eye. Sometimes, a black eye can be a sign of hyphema: bleeding in the eye. It can also be a sign of a skull fracture.

Hematomas and bruises may look similar, but they have different underlying complications. A contusion usually appears on the skin following a trauma, when the small capillaries under the skin break. 

Hematomas are a collection of blood outside of the blood vessels. They can be classified as spinal, subdural, subungual, or hepatic.

The causes of the contusion include:

• Small tears in blood vessels under the skin
• Bumps and accidents
• Thin skin from aging
• Unexplained bleeding disorders that occur without reason

Causes of hematomas include:

• Trauma
• Certain medications
• Aneurysms
• Orthopedic injuries
• Infections from viruses like mumps, rubella, or hepatitis c

Anyone can get a contusion, whether from an accident, participation in sports, or a medical procedure. The older you are, the more likely you are to bruise. Some bleeding disorders can lead to frequent bruising. However, there are other conditions that can put you at particularly high risk, for instance, if you:

• Have family members who easily bruise
• Have liver disease
• Have cancer
• Take  nonsteroidal anti-inflammatory drugs (NSAIDs), often for pain relief
• Take blood thinners or medicines that stop clotting
• Have a low blood platelet count, a condition known as thrombocytopenia.
• Suffer from bleeding conditions like  von Willebrand disease or  hemophilia
• Have deficiency in vitamin k or vitamin c

Symptoms of bruising include:

• A dark purple or blue patch of skin appears a few hours after an injury
• Tenderness around or on the affected area

Symptoms of a hematoma include:

• Swelling
• Tenderness
• Pain
• Inflammation
• Warmth
• Redness

Much can be told regarding the age of a bruise from the color. When your body breaks down red blood cells, the natural healing process kicks in, and the bruise changes colors. 

These are the typical color changes:

• Red: Fresh bruises often start as a red mark because oxygen-rich blood is pooling under the skin
• Purple, blue, or black: After a day or so, the leaked blood begins to lose its oxygen and again changes color. Depending on the location, size, and severity of the bruise, it can be purple, blue, or black.
• Yellow or green: 5 to 10 days after your injury, your bruise will turn greenish or yellowish. This is a result of the chemicals bilirubin and biliverdin. They are produced when the body needs hemoglobin broken down.
• Light brown or yellow-brown: Between 10 days and 2 weeks, the final stage of bruising results in a brownish lesion.

A contusion is of concern when the injury leads to severe symptoms, including:

• Dizziness
• Headache
• Confusion
• Vomiting
• Slurred speech
• Loss of consciousness
• Paralysis
• Seizure

The following areas of the body are more likely to suffer from severe complications following an injury:

• The head: Headaches, nausea, vomiting, confusion, and slurred speech may coincide with an intracranial hematoma.
• The face: Swelling of the eyes and the nose occurs with septal hematomas. They may also cause clear drainage from the nose or nose bleeds.
• The abdomen: Initially, an abdominal hematoma may not have any symptoms. Tenderness, pain, and swelling can later develop, though.

Along with your doctor, you can diagnose a contusion by its color and look. If frequent bruising from unknown causes occurs, your doctor will order tests to figure out the cause, including:

• Testing for bone fractures like X-rays  
• Testing for vitamin deficiencies and clotting disorders with blood tests

Contusions can be treated at home with rest, ice, compression, and elevation (or, RICE). For minor hematomas, swelling and pain can be treated with medications like Tylenol. However, hematomas located in certain areas that are symptomatic may need immediate medical or surgical treatment.

You should call your doctor, or go to the hospital if you have:

• Bruising that lasts over two weeks
• Recurrent large bruises
• Lumping in the bruised area  
• Recurrent bruises in the same location
• Unexplained bruising
• Pain that persists days after the injury
• Painful swelling
• Possible broken bone
• Weakness or numbness anywhere on the affected limb
• A black eye that obstructs vision
• Uncommon bleeding like nosebleeds, abnormal bleeding in the gums, and blood that accompanies urination or bowel movements