Hematoma Risks After 65: When Bruising Becomes Dangerous

Hematoma Risks After 65: When Bruising Becomes Dangerous

As we age, our bodies change in ways that can make injuries more complicated. One issue that deserves special attention after age 65 is a hematoma. While many people think of a hematoma as "just a bad bruise," in older adults it can sometimes signal a more serious problem. Understanding when a hematoma is harmless—and when it may be dangerous—can help you make informed, timely decisions about your health.

This article explains what a hematoma is, why risks increase after 65, warning signs to watch for, and when it's important to speak to a doctor.

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What Is a Hematoma?

A hematoma is a collection of blood that leaks out of damaged blood vessels and pools in surrounding tissue. It often happens after an injury, fall, or medical procedure, but it can also occur with minimal trauma in older adults.

Hematomas can form in different parts of the body, including:

• Under the skin (often appearing as a deep bruise)
• Inside muscles
• Around organs
• Inside the skull (such as a subdural hematoma)

Unlike simple bruising, a hematoma involves more significant bleeding and swelling. In some locations—especially the brain—it can become life-threatening if not recognized and treated.

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Why Hematoma Risk Increases After Age 65

Aging itself does not cause hematomas, but several age-related factors make them more likely and potentially more dangerous.

Key reasons risk increases include:

• More fragile blood vessels
  Blood vessel walls thin with age, making them easier to damage.

• Reduced protective tissue
  Loss of muscle and fat means less cushioning during minor impacts or falls.

• Blood-thinning medications
  Many adults over 65 take anticoagulants or antiplatelet drugs to prevent strokes or heart attacks. These medications increase bleeding risk.

• Balance and vision changes
  Falls become more common, even from standing height.

• Slower healing
  The body may take longer to stop bleeding and reabsorb pooled blood.

Because of these factors, a hematoma in an older adult can grow larger, last longer, and cause more complications than in younger people.

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Common Types of Hematoma in Older Adults

Not all hematomas are the same. Location matters greatly when it comes to risk.

1. Skin and Soft Tissue Hematoma

These appear as firm, painful, dark bruises.

• Often caused by bumps or minor falls
• Usually heal over weeks
• May feel warm or swollen at first

Most are not dangerous, but very large or painful ones should be checked by a doctor.

2. Muscle Hematoma

Bleeding inside a muscle can cause:

• Deep pain
• Limited movement
• Increasing swelling

In older adults, these may occur without a clear injury, especially when on blood thinners.

3. Abdominal or Organ Hematoma

Bleeding around organs such as the liver or kidneys may cause:

• Abdominal pain
• Weakness
• Dizziness or fainting

These always require medical evaluation.

4. Subdural Hematoma (Brain)

This is one of the most serious types and deserves special attention.

• Often follows a fall or head injury
• Symptoms may appear slowly over days or weeks
• Can occur even without hitting the head hard

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When Bruising Becomes Dangerous

Most bruises fade with time. A hematoma becomes concerning when it shows signs of ongoing bleeding, pressure on vital tissues, or infection.

Warning signs that should not be ignored include:

• Rapidly increasing size or swelling
• Severe or worsening pain
• Skin that feels tight, shiny, or very warm
• Numbness or weakness near the area
• Fever or redness spreading around the hematoma
• Bruising that appears without any known injury

In older adults, even "mild" symptoms can point to something more serious.

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Special Concern: Head Injuries and Subdural Hematoma

A subdural hematoma occurs when blood collects between the brain and its outer covering. After 65, the brain shrinks slightly, stretching veins and making them easier to tear.

What makes this condition especially dangerous is that symptoms can be subtle at first.

Possible symptoms include:

• Headache that does not go away
• Confusion or memory problems
• Drowsiness or changes in alertness
• Balance problems or frequent falls
• Slurred speech
• Personality or behavior changes

If you or a loved one has had a fall or head injury—no matter how minor—and any of these symptoms appear, it is important to act quickly. If you're experiencing concerning symptoms after a head injury, you can use a free online tool to check your symptoms for Acute Subdural Hematoma and help determine whether immediate medical attention is needed.

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How Hematomas Are Evaluated and Treated

When you speak to a doctor about a suspected hematoma, they may:

• Review medications (especially blood thinners)
• Perform a physical exam
• Order imaging tests such as ultrasound, CT scan, or MRI
• Check blood clotting levels

Treatment depends on severity and location:

• Observation for small, stable hematomas
• Compression, rest, and pain control
• Medication adjustments
• Drainage or surgery in severe cases, especially for brain hematomas

Early evaluation often leads to simpler treatment and better outcomes.

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Reducing Your Risk After 65

While not all hematomas can be prevented, there are practical steps that can lower your risk.

Helpful prevention strategies include:

• Fall-proofing your home (good lighting, remove loose rugs)
• Using mobility aids if recommended
• Reviewing medications regularly with a doctor
• Reporting frequent or unexplained bruising
• Wearing protective gear when appropriate

Staying physically active, within safe limits, can also improve balance and muscle strength.

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When to Speak to a Doctor Immediately

You should speak to a doctor or seek urgent medical care if a hematoma is associated with:

• A head injury
• Confusion, weakness, or trouble speaking
• Severe pain or pressure
• Sudden dizziness or fainting
• Use of blood-thinning medication
• Signs of infection

Anything that could be life-threatening or serious should never be "waited out."

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The Bottom Line

A hematoma after age 65 is not automatically dangerous, but it deserves respect and attention. Aging bodies respond differently to injury, and what looks like a simple bruise can sometimes hide a more serious problem. Paying attention to warning signs, using reliable tools to assess symptoms, and knowing when to speak to a doctor can make a critical difference.

If you ever feel unsure, trust that concern—it's better to ask and be reassured than to miss something important.