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What is a Subdural Hematoma?

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  • Written By: Amy Hunter
  • Edited By: Bronwyn Harris
  • Last Modified Date: 26 October 2016
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A subdural hematoma is a term used for a collection of blood on the surface of the brain. Subdural hematomas can be divided into two groups, chronic and acute. While each is serious conditions, acute hematomas have a much poorer prognosis.

An acute subdural hematoma is often the result of a significant brain injury. Damage to the veins in the head causes them to stretch and tear, leaking blood into the surrounding areas. Due to the limited amount of room under the skull, pressure builds up quickly, creating a medical emergency.

Chronic subdural hematomas take longer to develop and the damage is not typically as profound. Elderly people are particularly prone to chronic subdural hematomas. In the elderly, the brain often shrinks due to atrophy. When this occurs, it stretches the veins, causing them to leak blood under the dura, or outer covering of the brain. Some subdural hematomas occur spontaneously, with no known cause.

The main risk factors of developing a subdural hematoma are being very young, very old, suffering a brain injury, being on prescription blood thinners or a history of alcohol abuse. Anyone that loses consciousness after a head injury should be examined for a subdural hematoma. Also, someone experiencing headaches, weakness, numbness or lethargy should be evaluated. Nausea or vomiting, as well as slurred speech or difficulty speaking are all signs that someone may be experiencing a subdural hematoma.

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A subdural hematoma can be diagnosed by using an MRI or CT scan. A patient suffering from a subdural hematoma can be treated in several ways. The physician may choose to drill a small hole in the skull which allows the hematoma to drain. This also reduces pressure on the brain.

If the hematoma is more significant, the physician may be required to conduct a more aggressive procedure called a craniotomy. In this surgery, the physician will create a large opening in the skull in order to remove solid blood clots and allow the hematoma to drain. The procedure that the physician chooses will be based on the size of the hematoma and the patient’s general condition.

The prognosis for someone who experiences a subdural hematoma depends on a variety of factors. While the size of the hematoma is important in how the patient will respond to treatment, how quickly the patient receives care is a vital factor as well. After successful surgery to repair the hematoma, the patient may have long term complications. These may include weakness, difficulty speaking, memory loss, dizziness, headaches and difficulty concentrating.

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