Subdural Hematoma: Symptoms and Treatment

Overview

Subdural hematoma is a serious brain condition caused by traumatic head injuries. In a subdural hematoma, blood collects between the layers of tissue surrounding the brain—between the dura(the outermost layer), and the arachnoid(the next layer). Pressure on the brain increases as blood accumulates, leading to unconsciousness and even death if left untreated. Some subdural hematomas stop and resolve spontaneously, while others require surgical drainage. Acute subdural hematomas have been reported to occur in 5-25% of patients with severe head injuries. And there are more than 200,000 cases in the U.S.

Causes

There are two types of subdural hematomas: acute subdural hematomas and chronic subdural hematomas. Each type has its own causes.

Acute subdural
hematomas usually result from:

  • A sudden blow to
    the head, possibly caused by a fall, vehicle collisions, or an assault
  • Bleeding disorders
  • Bleeding
    thinners

Chronic subdural hematomas are mainly caused by:

  • Mild or repeated head injuries
  • The rupture of small veins on the outer surface of the brain
  • Brain shrinkage in the elderly

Symptoms

Common symptoms of a subdural hematoma consist
of:

  • Inability to speak or slurred speech
  • Loss of consciousness or coma
  • Seizures
  • Numbness
  • Severe headaches
  • Weakness or lethargy
  • Dizziness
  • Visual problems
  • Disorientation
  • Memory loss
  • Irritability
  • Personality changes
  • Difficulty walking
  • Hearing loss
  • Vomiting  
  • Altered breathing patterns

Diagnosis

A doctor usually goes through the following procedures to diagnose a subdural
hematoma:

  • A physical examination to reveal the head injury responsible for the symptoms
  • The patient’s symptoms and medical history to reveal an underlying condition
  • Head imaging techniques, either a computed tomography (CT) scan or magnetic resonance imaging (MRI), to visualize the skull and the brain and prove the existence of a subdural hematoma
  • Angiography used In rare circumstances

  • The Glasgow Coma Scale (GCS) used in emergency cases to assess the patient’s level of consciousness

Treatment

Treatment of a subdural hematoma varies by its type, size, location as well as the initial cause.

  • Careful
    monitoring with diagnostic imaging

For those who have been diagnosed with a mild
case of subdural hematoma, this is an advisable option.

  • A burr-hole
    surgery

This surgical approach is suitable for
patients whose subdural hematomas are small or due to chronic trauma. In its
process, small holes are drilled into the skull, and then subdural hematoma is
drained through small tubes.

  • A craniotomy

To perform a craniotomy, the doctor will
remove a small section of skull temporarily to drain the subdural hematoma.

  • Medications

The doctor may prescribe anti-seizure medications to treat or prevent seizures, one of the possible symptoms of subdural hematoma.

Medications may also be used to treat the patient’s brain injury. In particular, corticosteroids are often prescribed to reduce inflammation in the brain.

Keywords: subdural hematoma.

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