Definition

What is subdural hematoma?

A subdural hematoma is a collection of blood outside the brain. Subdural hematomas are usually caused by severe head injuries. The bleeding and increased pressure on the brain from a subdural hematoma can be life-threatening. Some subdural hematomas stop and resolve spontaneously; others require surgical drainage.

In a subdural hematoma, blood collects between the layers of tissue that surround the brain. The outermost layer is called the dura. In a subdural hematoma, bleeding occurs between the dura and the next layer, the arachnoid.

The bleeding in a subdural hematoma is under the skull and outside the brain, not in the brain itself. As blood accumulates, however, pressure on the brain increases. The pressure on the brain causes a subdural hematoma’s symptoms. If pressure inside the skull rises to very high level, a subdural hematoma can lead to unconsciousness and death.

How common is subdural hematoma?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of subdural hematoma?

Acute subdural hematomas cause symptoms right away. However, people with chronic subdural hematomas may have no symptoms at all.

Common symptoms of a subdural hematoma are:

  • Slurred speech
  • Loss of consciousness or coma
  • Seizures
  • Numbness
  • Severe headaches
  • Weakness
  • Visual problems

These symptoms are also signs of other very serious health conditions. Symptoms of chronic subdural hematoma can be similar to the symptoms of dementia, stroke, tumors, or other problems in the brain.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes subdural hematoma?

Subdural hematoma is usually caused by a head injury, such as from a fall, motor vehicle collision, or an assault. The sudden blow to the head tears blood vessels that run along the surface of the brain. This is referred to as an acute subdural hematoma.

People with a bleeding disorder and people who take blood thinners are more likely to develop a subdural hematoma. A relatively minor head injury can cause subdural hematoma in people with a bleeding tendency.

In a chronic subdural hematoma, small veins on the outer surface of the brain may tear, causing bleeding in the subdural space. Symptoms may not be apparent for several days or weeks. Elderly people are at higher risk for chronic subdural hematoma because brain shrinkage causes these tiny veins to be more stretched and more vulnerable to tearing.

Risk factors

What increases my risk for subdural hematoma?

There are many risk factors for subdural hematoma, such as:

  • Recent trauma
  • Coagulopathy
  • Advanced age (>65 years)
  • Anticoagulant use

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is subdural hematoma diagnosed?

People who come to medical attention after a head injury often undergo head imaging, usually with computed tomography (CT scan) or magnetic resonance imaging (MRI scan). These tests create images of the interior of the skull, usually detecting any subdural hematoma present. MRI is slightly superior to CT in detecting subdural hematoma, but CT is faster and more readily available.

Rarely, angiography may be used to diagnose subdural hematoma. During angiography (angiogram), a catheter is inserted through an artery in the groin and threaded into the arteries of he neck and brain. Special dye is then injected, and an X-ray screen shows blood flow through the arteries and veins.

How is subdural hematoma treated?

An acute subdural hematoma can only be treated in an operating room.

A surgical procedure called a craniotomy may be used to remove a large subdural hematoma. It’s normally used to treat acute subdural hematomas. In this procedure, your surgeon removes a part of your skull in order to access the clot or hematoma. They then use suction and irrigation to remove it.

For an acute subdural hematoma, a craniotomy may be a necessary life-saving procedure. But it still has risks. In one study, 18 percent of patients died within 30 days of the surgery.

A burr hole can be used to drain chronic subdural hematomas as well as acute ones that are smaller than one centimeter at the thickest point. First, your surgeon creates small holes in your skull and then places rubber tubes in them. The blood from the hematoma drains out through these holes. Though recovery rates vary, 80 to 90 percent of patients experience significant brain function improvement after this procedure.

Your doctor may prescribe anti-seizure medications to treat or prevent seizures that might be caused by the subdural hematoma. Medication may also be used to treat your brain injury. Corticosteroids are often prescribed to reduce inflammation in the brain.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage subdural hematoma?

The following lifestyles and home remedies might help you reduce your risk of subdural hematoma:

  • Always wear a seat belt when you are driving or riding in a car.
  • You may feel safer if you use an assistive device, such as a 4 prong (pointed) cane or a walker when walking. To keep from falling, remove loose carpeting from the floor. Using chairs with side arms and hard cushions will make it easier to get up or out of a chair. Put grab bars on the walls beside toilets and inside showers and bathtubs. These will help you get up after using the toilet or after bathing. Grab bars will also help to keep you from falling in the shower. You may want to put a shower chair inside the shower.
  • Avoid activities that are likely to cause falls.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: August 26, 2018 | Last Modified: August 26, 2018

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