SUBDURAL HEMORRHAGE & HEMATOMA
DESCRIPTIONSubdural hemorrhage and hematoma is 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 child does not remember it. The brain, meninges, (membranes that cover the brain), and blood vessels to the brain are involved.
Appropriate health care includes:
Physician's monitoring of general condition and medications.
Surgical exploration and removal of the clot.
SIGNS & SYMPTOMSRecurrent headaches that worsen each day.
Fluctuating drowsiness, dizziness, mental changes, or confusion.
Weakness or numbness on one side of the child's body.
Vomiting without nausea.
Pupils of different size (sometimes).
RISK FACTORSExcess alcohol consumption.
Use of mind-altering drugs.
Injuries occur more often after:
PREVENTING COMPLICATIONS OR RECURRENCEYour child should avoid head injury in the following ways:
Use seat belts in cars.
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.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory studies of blood and cerebrospinal fluid.
Hospital diagnostic tests, including arteriography (See Glossary).
Special studies that may include ultrasonography, CAT or CT scan, MRI, and radionuclide scan (See Glossary for all).
POSSIBLE COMPLICATIONSDeath or permanent brain damage, including partial or complete paralysis, behavioral and personality changes, and speech problems.
The degree of your child's 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.
HOME CAREThere is no self-treatment for your child. These suggestions apply to care at home following surgery.
MEDICATIONYour doctor may prescribe cortisone drugs to reduce swelling inside the child's skull.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITYYour child should stay as active as strength allows, working and exercising moderately and resting when tired.
If your child's speech or muscle control has been damaged, there may be a need for physical therapy or speech therapy.
DIET & FLUIDS
Your child should eat a normal, well-balanced diet. Vitamin and mineral supplements should not be necessary unless your child cannot eat normally.
OK TO GO TO SCHOOL?When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow. May take months following surgery.
CALL YOUR DOCTOR IF
Your child has had a head injury--even if it seems minor--and symptoms of subdural hemorrhage develop. This is an emergency!
The following occurs during or after treatment:
-- Temperature rises to 101F (38.3C) or higher.
-- The surgical wound becomes red, swollen, or tender.
-- Headache worsens.