A hematoma is collection of blood. Subdural hematoma is accumulation of blood in the space between the outer covering of brain called dura and the covering below it called arachnoid. This accumulation is on the outside of brain. In most cases, subdural hematoma is caused by severe head injury.
Sometimes it is also observed in elderly who have less severe head injury and those who are receiving anticoagulant therapies. A large subdural hematoma can put pressure on the brain and it can be life threatening event in some cases.
Causes Of Subdural Hematoma
Most cases of subdural hematoma are caused due to severe head injury.Fall from the height, vehicle collision, and blow on the head are some of the reasons for subdural hematoma. Sudden severe blow to the head can damage the blood vessels that lie on the surface of brain. Since the accumulation is caused due to an acute cause, it is called acute subdural hematoma.
A person having blood disorders or if a person is taking blood thinners, the possibility of subdural hematoma increases to a great extent. A small injury to the head can lead to extensive bleeding in the subdural space in such people.
In chronic subdural hematoma, tiny veins on the outer surface of brain get damaged. The symptoms may take weeks to appear. This is more common in elderly individuals. The brain shrinks in size in old people. The blood vessels are overstretched and they become more susceptible to get damaged.
Subdural hematoma can also result while doing lumbar puncture.
Symptoms Of Subdural Hematoma
Subdural hematoma can be mild, moderate or large sized. The symptoms may vary according to the amount of bleeding.
In a head injury having extensive bleeding in subdural space, the person may slip into unconsciousness and coma immediately.
Sometime after a minor head injury, the bleeding is slow and it may prolong for few days to develop a big hematoma to produce symptoms. The patient may feel confused and lose consciousness several days after the injury.
If the subdural hematoma is too slow growing the symptoms may take two weeks to develop.
Below are common symptoms of subdural hematoma.
- Severe headache.
- Confused state of mind.
- Behavioral changes.
- Vomiting and nausea.
- Vision problems.
- Slurred speech.
- Infants dry in high pitch.
Subdural Hematoma Treatment
Subdural hematoma is a serious condition. It depends on how severe the hematoma is. The treatment can depend on careful observation to immediate brain surgery.
- If there is a small subdural hematoma having mild symptoms, physicians usually recommend only observation.
- In severe hematoma that may cause compression on brain, the patient may require urgent surgery to release the pressure. There are several surgical techniques used to treat subdural hematomas.
- Surgeons often use burr hole incision to reduce the pressure and remove the hematoma.
- Craniotomy is another surgical procedure used to remove large subdural hematoma.
- Craniectomy is least used in more severe cases of subdural hematoma.
In some serious cases where the patient has become comatose, he may require critical care and life support system, including artificial respiration.