Subdural hematoma

Subdural Hematoma (SDH) is a type of intracranial hemorrhage, where blood accumulates in the subdural space between the brain's dura mater and the arachnoid mater. It is typically caused by head trauma that leads to tearing of the bridging veins. The condition can be life-threatening and requires prompt diagnosis and treatment.

Trauma subdural arrow

Signs and Symptoms[edit | edit source]

The signs and symptoms of a subdural hematoma may vary depending on its size, location, and the severity of the injury. They may include:

Headache
Confusion or altered mental status
Dizziness
Nausea and vomiting
Weakness or numbness on one side of the body
Slurred speech
Loss of consciousness
Seizures

Causes[edit | edit source]

Subdural hematomas are most commonly caused by head injuries, such as falls, motor vehicle accidents, and assaults. Other risk factors include:

Advanced age
Alcohol abuse
Blood clotting disorders
Long-term use of anticoagulants
Repeated head injuries (e.g., in contact sports)

Diagnosis[edit | edit source]

To diagnose a subdural hematoma, the following diagnostic tests may be performed:

Medical history and physical examination: The doctor will ask about any recent head injury, symptoms, and medical history.
Neurological examination: The doctor will assess the patient's cognitive function, motor skills, and reflexes.
Imaging studies: A CT scan or MRI of the head can provide detailed images of the brain and detect the presence of a subdural hematoma.

Treatment[edit | edit source]

Treatment options for subdural hematoma depend on the severity and size of the hematoma, as well as the patient's overall health. They may include:

Observation: For small, stable hematomas with mild symptoms, the doctor may recommend regular monitoring and follow-up imaging studies.
Medications: Diuretics, corticosteroids, or antiepileptic drugs may be prescribed to manage symptoms and prevent complications.
Surgical intervention: For larger hematomas or those causing significant symptoms, surgery may be necessary. Surgical options include:
- Burr hole trephination: A small hole is drilled into the skull to drain the hematoma.
- Craniotomy: A section of the skull is temporarily removed to access the hematoma and remove it.
- Craniectomy: A part of the skull is permanently removed to relieve pressure on the brain.

Prognosis[edit | edit source]

The prognosis for subdural hematoma depends on various factors, such as the size and location of the hematoma, the patient's age, and the presence of any underlying medical conditions. Early diagnosis and treatment can significantly improve the outcome.

Prevention[edit | edit source]

Preventing head injuries is the primary method of subdural hematoma prevention. This may involve:

Wearing helmets during high-risk activities
Fall prevention measures for the elderly
Avoiding alcohol abuse
Regularly reviewing medications with a healthcare provider to minimize the risk of bleeding

References[edit | edit source]

Evans, R. W. (2006). Subdural hematoma. In Evans, R. W. (Ed.), Diagnostic testing in neurology (pp. 343-345). Philadelphia, PA: W. B. Saunders Company.
Murthy, J. M. K. (2016). Subdural hematomas: An overview. Journal of Neurosciences in Rural Practice, 7(Suppl 1), S2-S6. https://doi.org/10.4103/0976-3147.181474
Shetty, S., & Bharath, R. (2019). Subdural hematoma. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532972/
Wilberger, J. E., & Maroon, J. C. (2016). Subdural hematoma. In Winn, H. R. (Ed.), Youmans and Winn neurological surgery (7th ed., pp. 3114-3121). Philadelphia, PA: Elsevier.

External Links[edit | edit source]

Subdural hematoma Resources
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