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Subdural haematoma

There are three membranes that cover the brain and spinal chord. Together they are known as the Meninges. The space between the two outer membranes is called the subdural space.

If a vein in the subdural space is torn, blood escapes into the subdural space and can cause a blood clot to form. This type of blood clot that forms between the brain and the outer membrane is called a subdural haematoma.

As it gets bigger, the blood clot presses on the brain, and can cause symptoms such as headache and confusion.

Types and Causes

There are two types of SDH.

Acute SDH - This type of haemorrhage arises from a trauma to the head e.g. car accident, assault, sporting accidents, falls, trips etc.

Chronic SDH - May arise from a trauma to the head or spontaneously. It is most common in infants or the elderly.

Symptoms of an acute subdural haematoma may become obvious within a few minutes of the head injury. Acute haematomas are characterised by:

  • Confusion
  • Drowsiness
  • Loss of consciousness

The symptoms of chronic subdural haematomas are:

  • Headache
  • Gradually developing confusion and drowsiness, and visual disturbance.

Both chronic and acute subdural haematomas may also include the following symptoms:

  • Seizures
  • Vomiting
  • Progressive muscular weakness
  • Paralysis on one side of the body

In both acute and chronic haematomas, symptoms are variable and likely to change. If you develop any of the above symptoms following head injury, it is important to seek medical advice immediately.

Diagnosis

A CT scan and/or MRI scan is performed in order to diagnose the SDH.

Treatment

In all cases, the treatment for subdural haematomas is determined by their size and location. Many people are able to make a swift recovery, with some residual symptoms such as drowsiness and weakness. However, if the haematoma has affected a large part of the brain, then the condition may prove to be fatal.

If you are found to have a subdural haematoma, you will normally be admitted to hospital for treatment. This often involves a surgical procedure in which blood is drained from the head through tiny holes made in the skull.

If the subdural haematoma is small and causes few symptoms, you may simply be monitored with regular scans. Blood clots sometimes clear without the need for surgery. Blood thinning drugs may also be given.

Following any sort of head injury, most hospitals will want to keep you under surveillance until the risk of a chronic haematoma forming has passed.

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