Subdural hematoma  Health Article

Definition

A subdural hematoma is a collection of blood on the surface of the brain.

Alternative Names

Subdural hemorrhage

Causes, incidence, and risk factors

Subdural hematomas are usually the result of a serious head injury. When one occurs in this way, it is called an "acute" subdural hematoma. Acute subdural hematomas are among the deadliest of all head injuries. The bleeding fills the brain area very rapidly, compressing brain tissue. This often results in brain injury.

Subdural hematomas can also occur after a very minor head injury, especially in the elderly. These may go unnoticed for many days to weeks, and are called "chronic" subdural hematomas. With any subdural hematoma, tiny veins between the surface of the brain and its outer covering (the dura) stretch and tear, allowing blood to collect. In the elderly, the veins are often already stretched because of brain atrophy (shrinkage) and are more easily injured.

Some subdural hematomas occur without cause (spontaneously).

The following increase your risk for a subdural hematoma:

• Anticoagulant medication (blood thinners, including aspirin)
• Long term abuse of alcohol
• Recurrent falls
• Repeated head injury
• Very young or very old age

Symptoms

• Confused speech
• Difficulty with balance or walking
• Headache
• Lethargy or confusion
• Loss of consciousness
• Nausea and vomiting
• Numbness
• Seizures
• Slurred speech
• Visusal disturbances
• Weakness

In infants:

• Bulging fontanelles (the "soft spots" of the baby's skull)
• Feeding difficulties
• Focal seizures
• Generalized tonic-clonic seizure
• High-pitched cry
• Increased head circumference
• Increased sleepiness or lethargy
• Irritability
• Persistent vomiting
• Separated sutures (the areas where growing skull bones join)

Signs and tests

Always get medical help after a head injury. Older persons should receive medical care if they shows signs of memory problems or mental decline. An exam should include a complete neurologic exam.

Your doctor may order a brain imaging study if you have any of the following symptoms:

• Confused speech
• Difficulty with balance or walking
• Headache
• Inability to speak
• Lethargy or confusion
• Loss of consciousness
• Nausea and vomiting
• Numbness
• Recent congitive decline in an elderly person, even without a history of brain injury
• Seizures
• Slurred speech
• Visual disturbance
• Weakness

A CT scan or MRI scan likely would be done to evaluate for the presence of a subdural hematoma.