Subdural hematoma - Understanding Subdural Hematoma: Causes, Symptoms, and Treatments - 08/Mar/2024

Subdural hematoma – Understanding Subdural Hematoma: Causes, Symptoms, and Treatments – 08/Mar/2024

Understanding Subdural Hematoma: Causes, Symptoms, and Treatments

A subdural hematoma is a type of hematoma—a collection of blood—occurring beneath the dura mater, the outermost protective covering of the brain. Subdural hematomas are usually the result of head trauma and can present serious complications, often necessitating swift medical attention. This article explores the different aspects of subdural hematomas, including their causes, symptoms, diagnosis procedures, treatment options, as well as prevention strategies.

The Mechanism Behind Subdural Hematoma Formation

Subdural hematomas form when blood vessels between the dura and the surface of the brain rupture. The bleeding can cause an accumulation of blood that forms a hematoma, which can compress the brain tissue and lead to significant health issues. There are two main types of subdural hematoma—acute and chronic—with acute subdural hematomas presenting quickly with symptoms due to the rapid collection of blood, while chronic subdural hematomas may take weeks or even months to become noticeable as they accumulate slowly.

Causes of Subdural Hematoma

Traumatic Head Injury

The most common cause of a subdural hematoma is head trauma, such as a fall, vehicle accident, or any incident that involves sudden impact to the head. This is often seen in contact sports or physical altercations.

Age-Related Changes

Elderly individuals are at a higher risk for developing chronic subdural hematomas because age-related brain shrinkage can stretch and weaken blood vessels.

Blood-Thinning Medications

Blood thinners can increase the risk of bleeding problems, including the development of subdural hematoma if head trauma occurs.

Alcohol Abuse

Chronic alcohol abuse can lead to a reduction in platelets or changes in other blood clotting factors, predisposing to a greater risk of subdural hematoma after an injury.

Certain Medical Conditions

Conditions that affect blood clotting or those involving blood vessel abnormalities can predispose individuals to subdural hematomas.

Symptoms of Subdural Hematoma

For Acute Subdural Hematoma:

– Loss of consciousness or coma
– Severe headache
– Nausea and vomiting
– Dizziness
– Confusion and disorientation
– Slurred speech
– Weakness or numbness in limbs

For Chronic Subdural Hematoma:

– Gradual headache
– Memory loss
– Difficulty speaking or swallowing
– Loss of appetite
– Changes in behavior
– Seizures

It is vital to recognize that in some cases, symptoms may be subtle or mistaken for other conditions such as a stroke or dementia.

Diagnosis and Treatment Options for Subdural Hematoma

A subdural hematoma is typically diagnosed with imaging tests—like CT scans or MRIs—which provide detailed images of the brain and can reveal the presence of bleeding. Once diagnosed, treatment depends on the size, type of hematoma, and severity of the symptoms.

Conservative Management

Small, asymptomatic chronic subdural hematomas may be managed conservatively with regular monitoring because they sometimes resolve on their own.


Different medications might be prescribed to control symptoms such as pain or to manage seizures if they occur. Adjusting blood-thinning medications may also be crucial.

Surgical Options

Surgical evacuation is often necessary for acute or large subdural hematomas. There are different surgical options, such as burr hole drainage, craniotomy (opening the skull), or craniectomy (removing a portion of the skull).

Complications and Prognosis

Complications may arise from subdural hematomas, including prolonged pressure on the brain leading to brain damage or stroke-like symptoms. The prognosis varies from case to case and largely depends on the rapid identification and treatment of the condition.

Preventing Subdural Hematomas

Safety Measures

Wearing proper protective gear during high-risk activities can significantly lower the incidence of head injuries leading to subdural hematomas.

Care with Medications

Regular check-ups for those on blood-thinning medication are essential to ensure dosage is not rendering them excessively prone to bleeding.

Balanced Lifestyle

A balanced diet, moderate alcohol consumption, and protective measures against falls for elders reduce overall risk factors associated with subdural hematomas.


  • The prevalence rates for chronic subdural hematoma range from 1.72 to 20.6 cases per 100,000 people each year, with higher incidence in older populations.
  • Surgical procedures show a high rate of success in treating subdural hematomas; however, recurrence rates range from 5% to 30%.
  • Mortality rates for acute subdural hematoma are high despite advancements in medical care.
  • Image description: An illustrated cross-section of a human head that features an area labeled as a “subdural hematoma” beneath the skull but above the brain tissue, depicting blood accumulation causing pressure on brain structures.