Subdural Hematoma

subdural hematoma brain

Last Updated December 20th, 2021

Overview

Motorcycle accidents, contact sports, falls or violent attacks are all scenarios in which head trauma is likely to occur. Injury to the head should be taken seriously, even if there are no outwardly visible signs of trauma. Temporary disorientation or mild concussion should not be dismissed lightly. Internal injuries, particularly in the region of the brain, can be critical and even life-threatening.

The impact from head trauma can cause blood vessels to burst and leak blood into the tissues surrounding the brain. This condition is known as a subdural hematoma. If there is a significant accumulation of blood, it begins to exert pressure on the brain and cause severe neurological symptoms. An acute subdural hematoma is associated with a very high risk of mortality.

 

Definition

subdural hematoma brain injuryA subdural hematoma is the pooling of blood between the protective layers of the brain or hematoma of ruptured blood vessels. The brain is surrounded by three layers of insulating membranes known as the meninges. The outermost of these is known as the dura.

When a head injury causes blood vessels to burst and leak blood into the space between the dura and the surface of the brain itself, a subdural hematoma is a result. Because the skull is rigid and unyielding, the escaped blood will exert pressure on the soft tissues of the brain. This is likely to occur in the event of severe head trauma and the patient may even go into a coma. Such a condition is known as acute subdural hematoma and can be fatal in the absence of prompt surgical intervention. A chronic subdural haematoma on the other hand involves slow and intermittent bleeding as a result of which symptoms may take longer to manifest.

 

Causes

Normally, blood is able to clot promptly in the event of internal bleeding. If, for some reason, this response is delayed or impaired, leakage is prolonged and blood can collect locally in the tissues forming a hematoma. This can occur in individuals suffering from an inherited clotting disorder such as haemophilia. Clotting may be impaired on account of certain medications, in which case it is an acquired condition. A fuller list of causes and potential risk factors follows below:

  • A head injury causing rupture of blood vessels.
  • Recurrent head injuries.
  • Having a blood clotting disorder such as haemophilia.
  • Having diabetes is associated with a higher risk of subdural haematoma.
  • Diseases that severely lower the numbers of platelets in the blood. This includes leukemia and viral infections such as dengue fever.
  • Taking chemotherapy, as this can impair blood clotting.
  • Taking blood thinners or anticoagulant medications.
  • Chronic alcoholism.
  • The risk is higher for individuals who are either very young or of advanced age.

 

Symptoms

subdural hematoma brainA minor rupture of capillaries may not produce noticeable symptoms and an individual may be normal for weeks before headaches and loss of consciousness begin to set in. An acute hematoma, on the other hand, is a serious condition warranting urgent medical intervention. It is characterized by an extensive accumulation of blood around the brain, putting pressure on it and compressing the nerves. This is responsible for severe neurological symptoms such as seizures and even coma. A list of possible indications follows below but it is unlikely for all of these to appear in any single case of subdural hematoma. The nature of symptoms is largely dependent on the extent of the hematoma, its rate of progress and its specific location.

  • Headache.
  • Numbness.
  • Nausea and/or vomiting.
  • Dizziness or loss of balance.
  • Weakness.
  • Slurred or incoherent speech.
  • Change in breathing patterns.
  • Disturbances in vision such as double vision.
  • Loss of memory.
  • Mental confusion.
  • Loss of consciousness.
  • Seizures.
  • Incontinence.
  • Behavioural changes.

 

Types of Subdural Hematoma

Depending on rapidity of onset of symptoms, a case of subdural haematoma may be differentiated as either acute, subacute or chronic. While this guideline can be helpful in clinical practice, it is rather fluid.

  • Acute: This is a critical condition characterised by sudden or immediate onset following an injury. It is to be treated as a medical emergency. Typically, this occurs when the bridging veins that cross the subdural space are ruptured on account of impact or injury. Fatality is likely in as much as 50-90% of instances.
  • Subacute: Symptoms may appear at any time roughly from 4 to 20 days after the occurrence of the injury.
  • Chronic: The injury may be a very minor one causing a small haematoma or it may be one that does not produce symptoms until weeks or months afterward. There may not even be any association with head trauma and in some instances no clear cause is identifiable. This condition could potentially develop from age related shrinkage of the brain or wear and tear of blood vessels such as the bridging veins. The bleeding itself may be slow and continuous. Otherwise, the haematoma may develop out of intermittent bleeding prompted by minor and recurrent injury. Symptoms appear gradually, although this is not to suggest that they may be less severe than in other cases.

 

Clinical complications

The situation becomes critical when pressure builds up within the cranium. The patient may be rendered comatose as a result. Under such conditions, the preferred course is to relieve pressure within the skull by means of surgical drainage. If this is not done in time, the patient may die. Even after treatment or recovery, the patient may be left with permanent disabilities.

 

Diagnosis

SUBDURAL HAEMATOMA comaA physical examination of the patient might reveal the head injury responsible for the symptoms. In those with milder symptoms and no visibly apparent signs of trauma, it is more challenging to correctly diagnose the condition.

However, the medical history of the patient may reveal an underlying condition such as haemophilia, diabetes or the use of blood thinners.

In emergency cases, the level of consciousness of the patient is assessed by means of test known as the Glasgow Coma Scale (GCS). This takes into account vision, speech and mobility. Acute subdural haematoma is usually characterised by a low GCS score.

The preferred course of diagnosis is to make use of imaging techniques to assess the condition of the central nervous system. Computerised tomography (CT) and magnetic resonance imaging (MRI) can accurately reveal the extent and location of the haematoma.

 

Treatment and prevention

Treatment 

  • Those who have been diagnosed with a mild case of subdural hematoma are kept under observation. Brain scans are taken frequently to monitor their condition.
  • In cases of moderate to severe subdural hematoma, surgery may be needed. A hole is drilled into the skull and the excess blood is drained out. This surgical procedure is known as a burr-hole surgery.
  • Another surgical procedure ,known as a craniotomy, can be performed. Here, a part of the skull is removed and the hematoma is drained.
  • A part of the skull is removed and the brain is left to swell up naturally, thereby releasing pressure. This procedure is known as craniectomy.

Prevention 

  • Wear protective headgear.
  • Do not let your children climb on unsteady platforms.
  • Monitor your children while they are climbing or going down a flight of stairs.
  • Do not take any head injury lightly.

 

 

Dos and Don'ts

Dos
  • Visit the doctor if you notice any of the symptoms, or if your symptoms have aggravated.
  • Use a protective headgear.
  • Ensure that you have strapped your child in their seat properly, to make sure that they do not fall and develop a head injury.
Don'ts
  • Take any head injury lightly, visit the doctor to get a check up done.
  • Put excess pressure on your head, this may cause additional bleeding.
  • Move your child around violently, doing so can cause head injuries.

 

 

 

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CA19.9 Test CA 19.9 is a cancer antigen that exists on the surface of cancer-causing cells. The levels of CA…
Top 6 remedies to treat a razor burn at home Symptoms of razor burn include bumps on the skin, redness, and irritation of the skin. Find easy and…
hYdroxycut pills
Hydroxycut: How safe are these so-called weight loss supplements? Hydroxycut is a blend of several different ingredients formulated to promote weight loss; powered by a key weight…
top 10 deadliest diseases
What are the top 10 deadliest diseases and what is causing them? What are the largest killers of human lives across the globe? Which diseases are the most fatal ones?…
kefir bottle
Kefir: Top reasons why this probiotic drink should be consumed by you Yet another remarkable fermented food, kefir is a much healthier version of yogurt. These chewy white grains can…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Fibromyalgia fatigue
HCG Diet: The dangers of using this diet to lose weight HCG is a natural hormone produced by both men and women that corresponds to fertility. But how is…
EMG electromyography
EMG- Electromyography EMG detects the presence, location, and extent of diseases that damage the nerves such motor neuron disease. Electromyography…
glutamine workout
Glutamine: Why is this the right choice for muscle-gain supplement? Glutamine can help you gain muscles and build higher immunity. Read more to find out how you can…
HSV-IgM test
Herpes Simplex Virus (HSV)-IgM Test The HSV-IgM class antibody is produced by the body a few days after an initial HSV infection and…
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
blood elements analysis
Vitamin Profile Your doctor will recommend you undergo the vitamin profile test if you are showing signs of either vitamin…
Turner syndrome and infertility
Infertility profile (women) The infertility profile tests in women are conducted to form a complete picture of the hormonal balance and…
tonometry
Tonometry Tonometry uses a device called tonometer to measure the pressure inside the eye. This pressure is depends upon…
complement c4 test
Complement 4 (C4) Test The Complement 4 or C4 test measures the level of the protein in the bloodstream, and is primarily…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
Bronchoscopy procedure
Bronchoscopy Bronchoscopy is a procedure where in a scope is inserted into the lung pathway to observe any growth…
Keto diet healthy
Keto Diet: Did you know you could eat fats to burn fats? Keto diet - A wonder diet that lets you eat fats and lose weight too! Read on to…
green poop causes
Green poop : What are the reasons and how can you correct it Ever sneak a peek down the toilet only to shockingly find green poop? Why does our poop turn…
Echocardiogram
Echocardiography – ECHO Echocardiography (commonly known as ECHO) is an imaging modality (similar to ultrasonography) used to visualize the interior of…
creatinine
Creatinine Test The level of creatinine in the blood is a significant indicator of the health of your kidneys. This…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
beta hcg test
Beta hCG Test A Beta hCG test measures the level of human gonadotropin hormones present in the blood that is primarliy…
Proteinuria and blood pressure
Hypertension Profile Hypertension profile is a panel of blood tests done to analyse the cause of hypertension or high blood…
Crossfit with rope
CrossFit: Now get the perfectly sculpted body with this explosive gym routine CrossFit is a fitness regimen that makes use of high-intensity exercises in a shorter period to achieve muscle…
GM Diet: The fastest way to lose weight or yet another hoax diet? General Motors started this trend of extreme dieting for 7 straight days to ensure its employees were able…
vital organ diseases
Common diseases that could cripple your vital organs Brain, heart, kidney, lungs, and liver - these vital organs are indeed vital for your survival. However, these…
free thyroxine ft4
Free thyroxine test (FT4) The FT4 or free thyroxine test is used to detect the level of free thyroxine of FT4 thyroid…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Top reasons why you need to pay attention to your vitamin B6 intake Vitamin B6- An essential water-soluble vitamin. Its deficiency leads to physical changes such as sores & glossy tongue…
Dragon Fruit – Blessing from Nature’s Basket Dragon fruit is packed with nutrients but low on calories. It is the dream food that can help…
blood ketone test
Blood Ketone (D3HB) Test The Blood Ketone Test measures and monitors the levels of ketone in the blood which is usually performed…
Milk Thistle skin
Milk Thistle: Find possible cures for fatal diseases in these purple blooms Milk thistle is well-known for treating liver conditions. However, did you know that it comes with a plethora…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…
understanding addiction
Addiction explained: An obsession that could cost you your life Is addiction a behavioral disorder? Or is it a chronic disease? How does addiction cause chemical and structural…
amylase test
Amylase Test Amylase test is done by checking the level of this protein in the blood sample and also in…
kidney stones
Kidney stones Kidney stones are solid substances made up of crystals. They can be of various sizes. Treatment depend on…
cytomegalovirus igm test
Cytomegalo Virus (CMV) – IgM Test The CMV antibodies include both IgM and IgG antibodies which are the immune system's response to a CMV…
folate test
Folate test The Folate test measures and monitors the levels of folic acid in the blood. This test is also…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
Juice Plus: Can you really replace actual fruits with pills?  Juice Plus supplements intend to fill nutritional gaps present in our daily diet. But how successful have they…
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…
Cardiolipin Antibody (ACL) –IgG Test The cardiolipin antibody IgG are responsible for the abnormal formation of clots in veins and arteries or phlebitis…
lipoprotein A
Lipoprotein (A) Test Lipoprotein (A) test is used to measure and monitor the levels of LDL(Low-Density Lipoprotein) in the bloodstream in…
Diabetes blood test
Diabetic Profile The diabetic profile is a set of tests used for testing and monitoring the various kinds of Diabetes…
Anti-Inflammatory foods: 18 foods to a disease-free you Anti-inflammatory foods are the foods which are known to reduce the inflammation as well as the pain from…

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