Subdural Hematoma - Symptoms, Causes, Treatment
What is Subdural Hematoma?
This is where blood accumulates outside your brain. When you see the word "hematoma" this refers to blood that accumulates under the surface of your skin. When a person has a hematoma it can happen in various parts of your body. Where it is located is how it is categorized. When a person has a hematoma it will be found within your skull. It is found under the tough outer layer of your membranes that surround your spinal cord and brain called the "dura mater".
The subdural hematoma can be broken down into two categories which are:
- Acute when the bleeding takes place at a quick rate and can happen immediately or within a few hours. This is the most serious form of a subdural hematoma.
- Chronic is when you have this type of subdural hematoma the pools of blood or blood clots developing over a time.
The symptoms of a subdural hematoma may be related to impaired thought processes, changes in the level of consciousness, or loss of sensory or motor function. Some of the other common symptoms may include:
- Speech that is slurred
- Having a headache
- Not having the ability to speak
- Coma or loss of consciousness even briefly
- Numbness that can be in different areas of your body
- Having a seizure
- Having problems with your vision
- Coordination or balance that might be impaired
- Nausea and vomiting
Symptoms that could be an indication of a life-threatening condition:
- A change in the level of alertness or consciousness like not responsive or passing out.
- A change in your mental status or having a sudden change in behavior like delirium, delusions, or lethargy.
- Head trauma
- Inability to move a part of your body.
- Having a severe headache
Symptoms in an infant or small child that may be life-threatening:
- Displaying unusually irritability or fussiness
- Lethargy or poor sleeping
- Feeding poorly
- High pitched cries
- Changes in head shape or size
Some people who have a chronic subdural hematoma may not have any symptoms at all. The symptoms of a subdural hematoma that a person has will usually depend on the rate of bleeding. For example:
- In a head injury that has sudden bleeding that is severe the person could immediately become unconsciousness and go into a coma.
- In a head injury the person for a few days may appear okay but then become slowly confused and in a few days become unconscious. This is because the bleeding rate is slower which causes the subdural hematoma to slowly enlarge.
- If the subdural hematoma is slow growing there may not be any symptoms that are noticeable for fourteen days or longer after the start of the bleeding.
In addition, they symptoms can vary from person to person depending not only on the size and rate of bleeding but also on any medical conditions and their age.
A subdural hematoma is usually caused from an injury to the head that can happen because of an accident, a fall, an assault, or a car accident. When your head has a sudden blow it tears your blood vessels which are beside the exterior of your brain, which is an acute subdural hematoma. You are more likely to develop a subdural hematoma if you are on blood thinners or have some type of bleeding disorder, such as with their blood clotting, in which even a minor injury could cause one. When you have a chronic subdural hematoma you have bleeding in the subdural space caused by the small veins on the outer surface of your brain tearing. This type of subdural hematoma is the one that you may not have any symptoms for days or even weeks. The people who are more at risk for a chronic subdural hematoma are the elderly because as you get older your brain starts to shrink some and as a result these small veins are more vulnerable to tearing because they are stretched more.
When a person has an acute subdural hematoma they usually develop from a:
- A blow to your head
- A car accident
When a person has a chronic subdural hematoma they usually develop from:
- Head injuries that are repeated or mild such as from repeated falls, especially in the elderly.
- No apparent causes sometimes.
If a subdural hematoma appears to be getting larger the surgeon may opt to drilling "burr holes" into your skull so the surgeon can suction the blood out to relieve the pressure that is being exerted on your brains by the excess blood. The holes are drilled over the subdural space. If the subdural hematoma should develop after surgery the blood would also have to be drained.
In addition to the surgical procedures to drain the excess blood from the subdural hematoma the physician may prescribe certain pain relievers or anti-inflammatory medications to help with the symptoms. Which medications would be prescribed would depend on the types of symptoms a person is having and how severe the subdural hematoma was. If the person was suffering from seizures then the physician would prescribe anti-convulsion medication.
Many times alcoholics are at more of a risk for developing subdural hematoma so they would have to refrain from drinking an excessive amount of alcohol. If you have a bleeding disorder or are on blood thinners and experience any type of head injury you should see your physician to see if you have or are developing a subdural hematoma.
Sometimes a subdural hematoma may require emergency surgery in order to help decrease the swelling in your brain and medication to help control any seizures that a person may have from the subdural hematoma. Your physician may prescribe a diuretic to help reduce the swelling in your brain. If there are blood clots you may have to have surgery to remove them. After suffering from a subdural hematoma your physician may send you to rehabilitation to help improve your functional ability and strengthen your body.