Subdural Hematoma: Causes and How to Treat

Written by Medicover Team and Medically Reviewed by Dr Krishna Haskar Dhanyamraju , Neurologists

Causes
Find a Doctor
Diagnosis
Treatment
FAQs
Book an Appointment

1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Subdural hematoma (SDH) is a serious medical condition resulting from bleeding between the dura mater and the brain's surface.

What Causes Subdural Hematoma?

Subdural hematoma occurs when blood collects between the brain and its outer protective covering, usually due to damaged blood vessels. The condition can develop from trauma, aging-related changes, or factors that increase bleeding risk. The causes such as:

Traumatic Brain Injury

Traumatic brain injury (TBI) is a leading cause of subdural hematoma. When the head is subjected to a violent impact, the brain can shift within the skull, causing blood vessels to tear and bleed into the subdural space. Common scenarios include falls, motor vehicle accidents, and sports injuries.

Age and Anticoagulant Use

Elderly individuals are more susceptible to subdural hematomas due to brain atrophy, which stretches the blood vessels, making them more vulnerable to tearing. Additionally, the use of anticoagulant medications, such as warfarin, increases the risk of bleeding, even with minor head trauma.

Alcohol Abuse

Chronic alcohol consumption can lead to liver dysfunction and coagulopathy, increasing the likelihood of subdural hematoma. Furthermore, alcohol abuse often correlates with higher incidences of falls and accidents, further exacerbating the risk.

What Are the Symptoms of Subdural Hematoma?

Symptoms of subdural hematoma can range from mild to life-threatening depending on the size and speed of bleeding. Early recognition is important for timely medical treatment.

Acute Subdural Hematoma

Acute subdural hematomas develop rapidly, usually within 72 hours of a traumatic event. Symptoms include:

Severe headache
Vomiting
Confusion
Slurred speech
Hemiparesis (weakness on one side of the body)
Seizures
Loss of consciousness

Chronic Subdural Hematoma

Chronic subdural hematomas develop slowly, over weeks or months, often with more subtle symptoms such as:

Persistent headache
Cognitive changes
Dizziness
Memory loss
Personality changes
Weakness or numbness

When Should You See a Doctor for a Subdural Hematoma?

Seek immediate medical care from a neurologist if symptoms suggest a brain injury. Early diagnosis can help prevent serious brain complications.

Severe or worsening headache
Confusion or drowsiness
Seizures
Loss of consciousness
Weakness or difficulty speaking

Find Doctors for Subdural Hematoma Treatment Near You

How Is Subdural Hematoma Diagnosed?

Diagnosis involves neurological evaluation and imaging studies to detect bleeding around the brain. Accurate diagnosis is essential for determining the most appropriate treatment approach.

Clinical Evaluation

The initial assessment includes a thorough medical history and physical examination. Clinicians will inquire about recent head injuries, anticoagulant use, and alcohol consumption. Neurological assessments are conducted to evaluate cognitive function, motor skills, and reflexes.

Imaging Studies

Imaging studies are essential for confirming the diagnosis. The most commonly used modalities include:

Computed Tomography (CT) Scan: This is the gold standard for diagnosing subdural hematomas. CT scans can quickly and accurately visualize the extent and location of the hematoma.
Magnetic Resonance Imaging (MRI): MRI provides more detailed images of the brain's soft tissues and can be useful in identifying chronic subdural hematomas.

What Are the Treatment Options for Subdural Hematoma?

Treatment for subdural hematoma depends on the hematoma's size, location, and the patient's overall health.

Conservative Management

Small, asymptomatic subdural hematomas may be managed conservatively with close monitoring. This approach typically includes:

Observation: Regular neurological assessments and follow-up imaging to monitor hematoma size.
Medical Management: Discontinuing anticoagulants, when safe, and managing symptoms such as headache and nausea.

Surgical Intervention

Surgical intervention is often necessary for larger or symptomatic subdural hematomas.

Burr Hole Evacuation

For smaller hematomas, a burr hole procedure may be sufficient. This involves drilling a small hole in the skull to allow the accumulated blood to drain, relieving pressure on the brain.

Craniotomy

A craniotomy is a more invasive procedure used for larger hematomas. It involves temporarily removing a portion of the skull to access and evacuate the hematoma. After the procedure, the bone flap is replaced.

Decompressive Craniectomy

In cases of severe brain swelling, a decompressive craniectomy may be performed. This involves removing a larger section of the skull to allow the brain to swell without being compressed. The bone flap is typically replaced once the swelling subsides.

Your health is everything - prioritize your well-being today.

Consult Subdural Hematoma Doctors Today

What is the Recovery Process for a subdural hematoma?

Recovery from a subdural hematoma varies depending on the severity of the hematoma and the patient's overall health.

Rehabilitation

Rehabilitation is often necessary to address cognitive and physical impairments resulting from the hematoma. This may include:

Physical Therapy: To improve strength, coordination, and mobility.
Occupational Therapy: To assist with daily activities and improve fine motor skills.
Speech Therapy : To address communication difficulties and cognitive impairments.

Follow-up Care

Regular follow-up appointments are essential to monitor recovery progress and detect any complications. Follow-up imaging studies, such as CT scans or MRIs, may be performed to ensure the hematoma has resolved.

Preventing Hematoma Recurrence

Preventing recurrence is crucial for long-term recovery and involves addressing the underlying risk factors.

Medication Management

Patients on anticoagulant therapy may require adjustments to their medication regimen to reduce the risk of future bleeding. This should be done under the supervision of a healthcare provider.

Lifestyle Modifications

Implementing lifestyle modifications can significantly reduce the risk of recurrence. These may include:

Fall Prevention: Installing grab bars, using non-slip mats, and ensuring adequate lighting in the home.
Limiting Alcohol Consumption: Reducing alcohol intake to minimize the risk of falls and liver dysfunction.
Regular Check-ups: Regular medical check-ups to monitor overall health and manage chronic conditions.