Chronic means old and subdural hematoma is the accumulation of blood between the surface of the brain and its outermost covering (the dura). So an old accumulation of blood between the surface and covering of brain is termed as chronic subdural hematoma.

It usually develops several days or weeks after bleeding or injury and may or may not produce any symptoms in the patient.

 Causes of chronic subdural hematoma

The major cause of hematoma is bleeding due to a head injury. The bleeding results in slow leakage and collection of blood over the surface of the brain. Very rarely, it may develop without any reason.

In addition to head injury, following factors increase the risk of development of chronic subdural hematoma:

  • Long-term heavy alcohol use
  • Long-term use of anti-inflammatory drugs or blood thinning (anticoagulant) medication
  • Blood clotting diseases
  • Head injury
  • Old age

 Symptoms of chronic subdural hematoma

Chronic case of subdural hematoma may remain asymptomatic for some time. Its symptoms depend upon the size and location of the hematoma:

  • Confused state of mind
  • Coma
  • Unconsciousness
  • Decreased or sudden loss of memory
  • Difficulty speaking, swallowing or walking
  • Drowsiness
  • Headache
  • Seizures
  • Nausea & vomiting
  • Problems with vision
  • Numb or weak face, arms, or legs
  • Lethargy
  • Paralysis

 Diagnosis of chronic subdural hematoma

Patient history, physical and neurological examination along with following diagnostic procedures is required to diagnose any hematoma in the brain:

  • Head CT
  • Head MRI

 Treatment of chronic subdural hematoma

The chronic hematomas that do not cause symptoms are just observed and monitored regularly. Treatment of symptomatic hematoma is done to control the symptoms and reduce or prevent permanent damage to the brain. It may include:

  • Anticonvulsant medications to control seizure
  • Corticosteroids to relieve inflammation
  • Surgery of the skull to take out the clot called craniotomy
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