A hematoma is a collection of blood. A subdural hematoma develops in the space between the brain and the skull. This pool of blood can put pressure on the brain and cause a range of symptoms.
This can be serious and life-threatening injury. You will need to seek medical care.
A subdural hematoma is most often caused by a head injury. The injury may be caused by traumas such as falls, car accidents, or physical abuse.
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Factors that increase your risk of a subdural hematoma include: Being of advanced age (due to greater risk of falls and weaker blood vessels)Playing high-impact sportsTaking blood thinning medication
Having a history of
heart attackAbusing alcohol
drugsBeing physically abused
If you have any of these risk factors, tell your doctor.
The blood may pool quickly or take some time to build up. This will affect how fast the symptoms develop. The subdural hematoma may be: Acute—symptoms appear soon after the injurySubacute—symptoms appear a few days after the injuryChronic—bleeding is slower and symptoms only appear weeks after the injury
After a head injury, a subdural hematoma may cause the following symptoms: Loss of consciousnessBruising around the head or eyesHeadacheNausea or vomitingPersonality changesLimb weaknessFatigue/sleepinessConfusionSpeech difficultiesVisual impairment
Seek medical care immediately if you have any of these symptoms after a head injury.
Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may also be referred to a specialist for additional testing.
Your doctor may need pictures of the brain and skull. This may be done with: CT scanMRI scan
Tests to assess brain function may include: Neurological examinationEEG
(electroencephalogram)—a noninvasive test used to evaluate brain function
Blood tests may also be done to look for signs of bleeding.
Talk with your doctor about the best treatment plan for you. Treatment will depend on the size and severity of the hematoma. It will also be based on your specific symptoms.
Treatment options include the following:
A minor injury with little or no symptoms may not need treatment. Your doctor may simply ask that you watch for any new symptoms. It can take days and weeks for some symptoms to develop.
These tests assess how well your brain is working. The tests may be repeated while you recover to help your doctor determine: How your recovery is progressingIf you are ready to return to high-impact activities
Medication may be given to relieve symptoms. Some medications may include: Antiseizure medication—if seizures have occurredSteroids—to decrease brain swelling.
Surgery may be needed to relieve pressure on the brain. Surgical procedures that may be considered include: A small hole may be made in the scalp and skull. It will allow the blood clot to drain out of the skull.A section of the skull may be removed. This is called a craniotomy.
To help reduce your chance of head injury, take these steps: Wear proper helmets when playing sports and riding a bike or motorcycle.Use a seat belt while traveling in car.Reduce the risk of a fall or injury. Safeguard your home and workplace.Have regular blood tests if you are taking blood thinning medicine.
Limit your alcohol intake to a moderate level. This means:
Two or fewer drinks per day for menOne or fewer drinks per day for women
Servadei F, Compagnone C, Sahuquillo J. The role of surgery in traumatic brain injury.
Curr Opin Crit Care.
Last reviewed November 2012 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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