Subdural Hematoma: Causes, Symptoms, and Treatment

What is Subdural Hematoma?

Imagine this scenario: you were playing football with friends and had a hard fall. A few weeks later, you start experiencing severe headaches and confusion. Could there be a connection? There might be more happening under your skull than you realise.

In simple terms, a subdural hematoma is bleeding inside the head. It occurs when blood gathers in the space beneath the dura mater, one of the three layers which protects your brain and spinal cord. Think of these layers as protective cushions around your brain: the outer layer is the dura mater (closest to the skull), the middle layer is the arachnoid mater, and the innermost layer is the pia mater (closest to the brain tissue). When a blood vessel breaks in this area due to reasons like a head injury, the leaking blood causes a subdural hematoma.

Notably, it falls under the category of traumatic brain injury (TBI) and can even prove fatal without immediate medical intervention. Let's now look at the different types of subdural hematomas that exist.

What are the Types of Subdural Hematomas?

The classification of subdural hematomas depends on three main factors: how quickly they develop, the extent of bleeding, and the damage they inflict.

Consequently, we have three types:

1. Acute Subdural Hematomas: This is the most dangerous type, in which severe symptoms appear immediately after a head injury, often within minutes to hours. Without quick diagnosis and treatment, it could cause unconsciousness, paralysis or even death.
2. Subacute Subdural Hematomas: Develops within two to 10 days of a head injury. Symptoms usually emerge hours to weeks after the head injury. These hematomas often accompany concussions.
3. Chronic Subdural Hematomas: Common in people over 65 years old, these result from slow bleeding and delayed symptom development. Even minor head injuries can cause chronic subdural hematomas.

How common are Subdural Hematomas?

Subdural hematomas aren't rare - they occur in approximately 1 in 4 people with head injuries. Therefore, it's important to understand their subdural hematoma symptoms to seek immediate medical help when needed.

What are the Symptoms of Subdural Hematoma?

Subdural hematoma symptoms can vary greatly based on the size of the hematoma, how quickly the bleeding occurs, and the person's overall health.

Common symptoms include:

• Headache: Often the most prominent symptom, which may be persistent and worsen over time
• Nausea and Vomiting: Patients may experience gastrointestinal distress due to increased intracranial pressure
• Drowsiness: Individuals may feel unusually sleepy or have difficulty staying awake
• Confusion: Altered mental status can manifest as confusion, disorientation, or difficulty concentrating
• Dizziness or Balance Issues: Affected individuals may have trouble maintaining balance or feel lightheaded
• Slurred Speech: Communication difficulties may arise, impacting clarity and coherence
• Seizures: Some patients may experience seizures as a result of increased pressure on the brain
• Weakness or Numbness: Typically observed on one side of the body, which may indicate neurological impairment
• Vision Problems: This can include blurred or double vision, impacting the ability to see clearly
• Loss of Consciousness: In severe cases, individuals may become unresponsive or enter a coma

It's crucial to seek medical attention if these symptoms arise, especially following a head injury.

What Causes Subdural Hematomas?

A subdural hematoma primarily results from a head injury due to a fall, vehicle collision, or assault. Think of it this way: the sudden blow to the head tears blood vessels that run along the brain's surface, leading to an acute subdural hematoma. People playing contact sports like football or boxing are particularly at risk, as are newborn infants due to their soft skulls. Moreover, individuals with bleeding disorders or those on blood thinners also face a higher risk of developing a subdural hematoma.

What are the Risk Factors for Subdural Hematoma?

Aside from the subdural hematoma causes mentioned above, certain risk factors elevate the chances of a subdural hematoma.

These include:

• Age over 60 years
• Chronic alcoholism
• Long-term use of anticoagulants
• History of falls or repeated head injuries

How is Subdural Hematoma Diagnosed?

A CT scan is commonly used to diagnose a subdural hematoma. This scan combines X-rays and computer technology to produce detailed images of the inside of your body, helping to determine if there is any blood accumulation between your skull and brain. In certain situations, an MRI scan may be used as an alternative.

How are Subdural Hematomas Treated?

Subdural hematoma treatment primarily depends on the size, location, and severity of the hematoma, as well as the patient's overall health. The primary goal of treatment is to relieve pressure on the brain and prevent further complications.

• The most common procedure is craniotomy, in which a particular section of the skull is removed to access the hematoma directly. The surgeon will drain the blood, and the skull is replaced afterward.
• For smaller or asymptomatic hematomas, doctors may opt for observation and regular monitoring, allowing the body to reabsorb the blood naturally over time.
• In cases of large or symptomatic hematomas, surgical intervention is often required.

Possible Surgery Complications

Surgery carries inherent risks. Possible subdural hematoma complications can include infection, excessive bleeding, or brain swelling. Additionally, patients may also experience neurological deficits post-surgery, such as weakness or changes in speech, depending on the hematoma's location and the brain areas affected. In some cases, repeat surgery may be necessary if the hematoma re-accumulates.

Patients should also be aware that they may experience cognitive or physical impairments during recovery, which might necessitate rehabilitation therapies to regain lost functions.

Recovering from a Subdural Hematoma

Recovery from a subdural hematoma varies significantly based on individual factors, including age, overall health, and the extent of the hematoma. After surgery, patients typically undergo a rehabilitation program tailored to their needs. This may involves a physical therapy, occupational therapy, and speech therapy to address any deficits.

Ongoing medical follow-up is essential to monitor recovery and manage any long-term effects. Some individuals may experience fatigue, headaches, or mood changes during the recovery phase, which can last weeks to months. Support from family and caregivers plays a vital role in the healing process, ensuring a smoother transition back to daily life.

What is Outlook for Someone with a Subdural Hematoma?

The recovery time varies from individual to individual – while some people might recover in a few weeks, others may not fully recover at all.

What are the Complications of Subdural Hematoma?

Subdural hematoma complications can differ in severity and impact the patient's recovery.

• One of the most common issues is increased intracranial pressure, leading to headaches, nausea, and potentially loss of consciousness.
• Other complications includes seizures, neurological deficits, as well as cognitive impairments, which may result from pressure on the brain or damage to brain tissue.
• In some cases, re-accumulation of blood may necessitate an additional surgical intervention.
• Additionally, patients may face long-term effects like memory issue, personality changes, and difficulty with coordination.

Early diagnosis and treatment are important to reduce these complications and improving outcomes.

Conclusion

While subdural hematomas may seem serious, they can be managed effectively with timely medical intervention. Always consult your healthcare provider for personalised advice and treatment.

For those who need regular health check-ups or looking for a reliable diagnostic services, Metropolis Healthcare's provides dependable pathology testing and the convenience of at-home sample collection, delivered right to your door. Take charge of your health today with Metropolis Healthcare—because every test is important for your well-being!

For individuals who need regular health check-ups or diagnostic services, Metropolis Healthcare's offers reliable pathology testing and convenient at-home sample collection right at your doorstep. Take control of your health today with Metropolis Healthcare- because when it comes to health, every test matters!