Subdural Hematoma

A subdural hematoma is a type of bleeding that occurs between the dura mater (the brain's outer membrane) and the arachnoid membrane. It is typically venous in origin and often develops after a blow to the head.

Characteristics

• The bleeding can progress slowly.

• It is more commonly seen in elderly individuals (due to brain atrophy) or in those taking anticoagulant medications.

• It has three forms: acute, subacute, and chronic:

  • Acute: Symptoms appear within the first 72 hours after trauma.

  • Subacute: Develops within 3 to 7 days.

  • Chronic: Appears weeks or months later.

Symptoms

• Headache

• Confusion or loss of consciousness

• Balance and walking difficulties

• Hemiplegia (weakness on one side of the body)

• Speech impairments

• Personality changes or memory loss (especially in the chronic type)

Diagnosis

• Computerized Tomography (CT): Acute subdural hematoma appears as a concave (crescent-shaped) hyperdense area. In chronic cases, the density may be lower (hypodense).

Treatment

• Emergency surgery: In large or symptomatic hematomas, craniotomy or burr hole (small hole) surgery is performed to drain the blood.

• Small and asymptomatic hematomas may be monitored.

Outcome

• Early diagnosis and intervention can lead to good outcomes, but the risk is higher in elderly patients or those with poor overall health.