What is subdural hematoma?

A subdural hematoma is a collection of blood underneath the dura mater, the tough outer layer of the meninges, the membranes that surround the brain and spinal cord. The bleeding comes from small veins that cross over the brain, between it and the dura mater. An enlarging subdural hematoma can push against the brain, leading to tissue compression and displacement of vital structures.

Subdural hematomas are almost always caused by head trauma, although in rare cases, they can occur spontaneously. Serious head injuries can cause acute subdural hematomas, in which the torn veins bleed rapidly into the subdural space, and pressure on the brain builds quickly. Acute subdural hematomas can occur in any age group. Young children with acute subdural hematomas due to nonaccidental trauma often harbor other signs of physical abuse.

Chronic subdural hematomas are more common in the elderly, in whom the veins in the subdural space are stretched due to atrophy, or shrinkage, of the brain. Seemingly minor injuries can cause these fragile veins to break. Blood accumulates and pressure builds more slowly, so symptoms may take days or weeks to occur. Sub-acute subdural hematomas, in which the bleeding is faster than in a chronic subdural hematoma, but not as fast as that in an acute subdural hematoma, can also occur.

Symptoms of subdural hematomas include confusion, headache, movement difficulties, loss of sensation, visual changes, speech difficulties, seizures, lethargy, vomiting, and loss of consciousness. In infants, the fontanelles (“soft spots”) may bulge, the head may increase in size, cries may be high pitched or shrill, and irritability or feeding difficulties may occur. Emergency surgery may be required to relieve pressure on the brain and medications may be given to reduce brain swelling or control seizures.

A subdural hematoma is always a medical emergency and needs to be treated as quickly as possible to save as much brain tissue as possible. Seek immediate medical care (call 911) for significant head trauma, severe headache, confusion, loss of sensation or the ability to speak, lethargy, loss of consciousness or alertness, or symptoms such as shrill, high-pitched cries, poor feeding, unusual irritability, or changes in head shape or size in an infant.


SYMPTOMS

What are the symptoms of subdural hematoma?

Symptoms of subdural hematomas can be related to loss of motor or sensory function, impaired thought processes, or changes in level of consciousness. Other symptoms can include pain, nausea and vomiting, and seizures. Infants may exhibit unusual irritability, poor feeding, or lethargy. Their cries may be high pitched and cha... Read more about subdural hematomasymptoms

CAUSES

What causes subdural hematoma?

Subdural hematomas are almost always caused by head trauma. Serious head injuries can cause acute subdural hematomas. In the elderly, chronic subdural hematomas may result from more minor head injuries. On rare occasions, subdural hematomas can form spontaneously.

What are the risk factors for subdural hematoma?

A number of factors increase the risk of developing subdur... Read more about subdural hematomacauses

TREATMENTS

How is subdural hematoma treated?

Treatment of a subdural hematoma may require emergency surgery and use of medications to decrease brain swelling and control seizures.

Common treatments of subdural hematoma

Common treatments of subdural hematoma include:

Medical Reviewer: William C. Lloyd III, MD, FACS Last Annual Review Date: May 7, 2014 Copyright: © Copyright 2014 Health Grades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Health Grades, Inc. Use of this information is governed by the HealthGrades User Agreement.

This Article is Filed Under: Brain and Nerves