Acute Subdural Hematoma


An Acute subdural hematoma (SDH) or Blood Clot in Brain is a collection of blood (clot) between the surface and outer covering of the brain. It is a serious condition that is most lethal among all head injuries.

Cause of Subdural Hematoma

The main cause of hematoma formation in subdural space is severe head injury from fall, motor vehicle collision, or a physical assault. But in some cases, minor bumps to the head can also lead to a subdural haematoma. The sudden blow causes tearing of blood vessels and results in bleeding and collection of blood between the dura and the next layer, the arachnoid.

Risk factors of Subdural hematoma

In addition to head injury, following factors also increase the risk for subdural hematoma:

  • Anticoagulant medication (blood thinners, including aspirin)
  • Long-term abuse of alcohol
  • Medical conditions that make your blood clot poorly
  • Bleeding disorder
  • Recurrent falls
  • Repeated head injury
  • Very young or very old age

Symptoms of Subdural hematoma

The accumulation of blood also increases pressure inside the brain and causes following symptoms of subdural hematoma in the person:

  • Worsening headache
  • Feeling of being sick
  • Lethargy
  • Confused state of mind  or speech
  • Personality changes, such as being unusually aggressive or having rapid mood swings
  • Drowsiness
  • Difficulty with balance or walking
  •  Unconsciousness and death (if pressure rises very high)
  • Nausea and vomiting
  • Numbness
  • Seizures
  • Visual disturbances
  • Weakness

Treatment of Subdural Hematoma

Some of the subdural hematomas stop and resolve spontaneously but others require treatment depending upon their size, location, severity and health of the patient. Treatment may include:

  • Observation in case of small subdural hematomas with mild symptoms
  • Medication with diuretics, corticosteroids or anticonvulsants may be used to control or prevent seizures.
  • Severe or dangerous subdural hematomas require any of the following surgery:
  • Burr hole trephination
  • Craniotomy
  • Craniectomy
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