SUBDURAL HEMORRHAGE & HEMATOMA

General Information

DEFINITION--Bleeding (hemorrhage) that causes blood to collect and clot (hematoma) beneath the outermost of 3 membranes that cover the brain (meninges). There are 2 types of subdural hematomas. An acute subdural hematoma occurs soon after a severe head injury. A chronic subdural hematoma is a complication that may develop weeks after a head injury. The injury may have been so minor that the patient does not remember it.

BODY PARTS INVOLVED--Brain; meninges; blood vessels to the brain.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Recurrent headaches that worsen each day.
• Fluctuating drowsiness, dizziness, mental changes or confusion.
• Weakness or numbness on one side of the body.
• Vision disturbances.
• Vomiting without nausea.
• Pupils of different size (sometimes).

CAUSES--Head injury.

RISK INCREASES WITH--

Injuries occur more often after:

• Use of anticoagulant drugs.
• Excess alcohol consumption.
• Use of mind-altering drugs.

HOW TO PREVENT--

Avoid head injury in the following ways:

• Use seat belts in motor vehicles.
• Wear protective head gear during contact sports, or while riding a bicycle or motorcycle.
• Don't drink alcohol or use mind-altering drugs and drive.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies of blood and cerebrospinal fluid.
• Hospital diagnostic tests, such as x-ray, arteriography, radionuclide scan and CT scan (See Glossary for all).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization for emergency treatment.
• Surgical exploration and removal of the clot.

POSSIBLE COMPLICATIONS--Death or permanent brain damage, including partial or complete paralysis, behavioral and personality changes, and speech problems.

PROBABLE OUTCOME--The degree of recovery depends upon general health, age, severity of the injury, rapidity of the treatment, and extensiveness of the bleeding or clot. After the clot is removed, brain tissue that has been compressed usually expands slowly to fill its original space. The outlook is good under the best circumstances.

How To Treat

GENERAL MEASURES----There is no self-treatment. These suggestions apply to care at home following surgery.

MEDICATION--Your doctor may prescribe drugs to reduce swelling inside the skull.

ACTIVITY--During recovery--stay as active as your strength allows. Work and exercise moderately. Rest when you tire. If your speech or muscle control has been damaged, you may need physical therapy or speech therapy.

DIET--Most likely will require intravenous or tube feeding during acute phase and then shift to regular food as tolerated.

Call Your Doctor If

• You have had a head injury--even if it seems minor--and you develop any symptoms of subdural hemorrhage. This is an emergency!
• The following occurs during or after treatment: Fever. Surgical wound becomes red, swollen or tender. Headache worsens.