What is a subdural hematoma?
A subdural hematoma is a collection of blood between the surface of the brain and the overlying skull. The blood puts pressure on the brain, leading to neurological symptoms. Most cases of subdural hematomas result from head injury.
Types of subdural hematomas
Subdural hematomas may be classificed as acute (sudden) or chronic (long-lasting). Acute subdural hematomas usually result from serious head trauma. The blood fills the brain area rapidly and displaces the brain. Coma and death may result from the pressure on the brain.
Chronic subdural hematomas can result from mild head trauma and may go on for many days or weeks before symptoms arise. This is more common in the elderly.
Subdural hematomas can, on occassion, occur spontaneously without any trauma or other known cause.
The risk of developing a subdural hematoma increases with age, alcohol use and use of anticoagulants, such as heparin or coumadin (warfarin)
Symptoms of subdural hematomas
- Difficulty or inability to speak
- Nausea and vomiting
A CT scan or MRI scan may be ordered if a sudural hematoma is suspected.
A subdural hematoma requires urgent treatment.
Emergency surgery may be needed to reduce pressure within the brain. This may involve drilling a small hole in the skull, which relieves pressure and allows the blood to drain. A craniotomy, which opens a portion of the skull, may need to be performed to treat a large hematoma. Anti-convulsant medications may be recommended to control or prevent seizures.
Many people with subdural hematomas survive without any long-term symptoms if treated early. However, some permanent damage to the brain may occur.
The long-term consequences depend on the type of head injury, the location of the brain affected, the size of the hematoma, and the lenght of time between injury and treatment.
Acute subdural hematomas are the most likely to be fatal and lead to long-term symptoms. Chronic subdural hematomas often have good outcomes and symptoms may resolve after the blood is removed.
Some long-term symptoms include:
- Weakness or paralysis
- Numbness in the extremities
- Difficulty speaking (aphasia)
- Seizures (these can often be controlled with medication)
- Memory loss
- Difficulty concentrating
Always protect your head in situations where you are at risk of head trauma. Be sure to always wear a helmet when riding a bike, horse or motorcycle. Regularly wearing a seat belt also protects the head from injury. Homes should be made safe for the elderly who may be at risk of falls. This may include securing rugs or carpets, installing handrails, and providing sufficient lighting.
Call 911 or your local emergency number, or go immediately to an emergency room.