Whether the patient is yourself or a loved one, learning more about subdural hematomas can help you feel more at ease. Self-education can be a powerful way to feel more comfortable amidst the stress of a medical diagnosis. To assist you, the following information explains more about subdural hematomas, the associated symptoms and treatment options available to patients in northern NJ.

What is a Subdural Hematoma?

The brain is covered by a thin protective membrane called the dura. A subdural hematoma is a blood clot that develops between this membrane and the brain itself. A blood clot can occur because blood vessels between the brain and dura have torn or if there has been damage to the brain itself. The cause is typically some form of head trauma. However, the injury may not necessarily be severe, particularly in elderly patients.

As a person ages, the brain atrophies, or shrinks. When this happens, the delicate blood vessels between the brain and dura stretch more and more, increasing their likelihood of tearing. As a result, even a slight trauma can lead to tearing, either in a single acute episode or many small tears over time (chronic).

If the subdural hematoma is large enough, it can put pressure on the brain, which can lead to symptoms and cause permanent damage. If the bleeding continues, the subdural hematoma can continue to grow, increasing the danger of complications. The subdural hematoma can also cause an increase in intracranial pressure, which decreases the blood flow to the brain, leading to ischemia and further damage.

Subdural Hematoma Symptoms

Because a subdural hematoma is commonly related to a head injury, the symptoms you experience will depend on your individual circumstances. If you have had a recent head injury and are experiencing any of the following symptoms, it is imperative you seek medical attention immediately. Time can be an important factor in preventing critical, irreversible complications.

Subdural hematoma symptoms can include:

  • Obvious trauma to the head or scalp
  • Severe headache
  • Dizziness
  • Paleness
  • Nausea or vomiting
  • Confusion
  • Seizures
  • Loss of consciousness
  • Blurred vision
  • Slurred speech
  • Difficulty with balance or walking
  • One pupil larger than the other
  • Blood or clear fluid draining from the nose or ears
  • Short-term memory loss, including being unsure of the cause of trauma
  • Behavioral changes, such as irritability
  • Weakness in one side of the body

With a chronic subdural hematoma, there may be few or no symptoms. However, symptoms include:

  • Headaches
  • Nausea and vomiting
  • Personality changes, including irritability
  • Cognitive dysfunction, confusion and memory loss
  • Difficulty with motor skills, including walking and balance
  • Decreased level of consciousness
  • Inability to communicate or understand language

Diagnosing Subdural Hematoma

If your doctor suspects a subdural hematoma based on your symptoms and/or history of traumatic head injury, he or she will use imaging to confirm the diagnosis. Either a computed tomography (CT) scan or magnetic resonance imaging (MRI) can be used to visualize the skull and brain. This will provide your doctor with information about the presence of any subdural hematoma, as well as its size and exact location.

Subdural Hematoma Treatment Options

Treatment of a subdural hematoma will depend on whether it is acute or chronic, its size and location, as well as the initial cause. When there is a traumatic accident, there are often many aspects being managed at once. However, understanding what can be done to treat a subdural hematoma can be helpful.

There are cases when a subdural hematoma may not require treatment. Instead, your doctor may recommend careful monitoring using diagnostic imaging. This may be an option for a small, asymptomatic subdural hematoma or if you cannot undergo surgery because of other health complications. Your doctor may also recommend medication to help prevent seizures or brain swelling due to the subdural hematoma.

However, the most common treatment for a subdural hematoma is surgery. There are different types of subdural hematoma surgery, and your neurosurgeon will make a treatment recommendation depending on the cause of the bleeding, as well as the size and location of the blood clot. The overall treatment goal is to remove the blood trapped between the dura and brain, preventing further damage and relieving any pressure that has built up.

One surgical approach, commonly used for a large subdural hematoma, requires a craniotomy. This is the temporary removal of a small section of skull to provide the surgeon with access to the subdural hematoma. The clot is removed and repairs to vessels may be made. The section of bone is replaced, and the soft tissues are closed using sutures or staples.

If the subdural hematoma is small or due to chronic trauma, the surgeon may be able to drain the build-up of blood without performing a craniotomy. Instead, small holes (burr holes) are drilled through the skull at the site of the subdural hematoma, and the hematoma is drained through small tubes. This will help relieve pressure and eliminate the risk of further damage.

Working with an Expert

There are a lot of things that can lead to a subdural hematoma, but they are all some form of trauma. If you or a loved one have experienced a head injury or suspect a subdural hematoma for any reason, be sure to seek medical attention and the advice of an expert quickly.

The brain is a delicate area of the body within a tight space, and it does not handle sharing its space with a blood clot well. It is important to work with an expert within the Tri-state area who understands and recognizes the signs of a subdural hematoma to ensure you receive an accurate and timely diagnosis. This way, if you do require subdural hematoma surgery, it can happen as soon as possible, reducing the risk of lasting complications.

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