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Chronic Subdural Hematoma

Overview

A brain disorder involving a collection of blood in the space between the inner and the outer membranes covering the brain,where symptoms usually develop within a short time after a head injury. Subdural means "below the dura" (the dura mater is the outer membrane covering the brain).

Chronic subdural hematoma occurs in about 1 out of 10,000 people.


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Causes

Subdural hematoma developswhen blood veins that are located between the membranes covering the brain (the meninges) leak blood after an injury to thehead. The head injury could be as obvious as a traumatic accident or as trivial as a minor bump to the head. Blood collects into amass (hematoma) that presses on the tissues of the brain. Pressure damages the brain tissue and causes loss of brain functionthat may progressively worsen as the hematoma enlarges and intracranial pressure (pressure within the head) increases. Theinjury and the resulting collection of blood cause inflammation of the brain tissues, which leads to swelling (cerebral edema).Cerebral edema further increases the intracranial pressure.Subdural hematoma often develops as a complication after a head injury. Symptoms of subdural hematoma may develop evenafter symptoms of the head injury (such as decreased consciousness) have improved. Acute subdural hematoma progressesrapidly, with symptoms usually appearing within 24 hours of the injury. Rapid deterioration occurs thereafter. Subacutesubdural hematoma usually develops symptoms within 2 to 10 days after the injury because of a slightly slower leakage of bloodinto the subdural area. Typically, symptoms of the original injury improve for a period, followed by development of symptomsof subdural hematoma.Risks include head injury, very young or old age, chronic use of aspirin, chronic use of anticoagulant medication (bloodthinners), and alcoholism or chronic alcohol use . Other important risk factors include any disorder that may result in a risk offalling, particularly disorders where confusion and cognitive impairment are already present and may mask symptoms ofacute/subacute subdural hematoma.Subdural hematoma occurs in people of all ages. Acute/subacute subdural hematoma is less common, but more often fatal, thanchronic subdural hematoma.


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Signs & Symptoms

recent injury or trauma to the head- loss of consciousness after original injury- may or may not regain consciousness for a period of time- decrease in alertness after initial awakening- drowsiness- headache, steady or fluctuating- impaired vision- visual loss (blindness)- left eye- right eye- eyes retract into the socket (enophthalmos)- eyelid drooping on one side only (unilateral)- decreased sensation or numbness- lower extremities (right leg or left leg)- upper extremities (right arm or left arm)- face (right side of face or left side of face)

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Prevention

Acute/subacute subdural hematoma may not be preventable once a head injury has occurred.Minimize the risk of head injury by using appropriate safety equipment and safety precautions in sports or recreation and work.For example, use hard hats, bicycle or motorcycle helmets, and seat belts. Do not dive into water if the depth of water isunknown or if rocks may be present under the surface of the water.


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Treatments
Craniotomy Modern Medicine

Chronic subdural hematoma is condition of surgery.

Immediate surgery is performed to low down the pressure within the brain.This procedure is called Craniotomy.medicines are also given to reduce swelling and to prevent seziures.

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