Subdural Hematoma

What is a subdural hematoma?

Subdural hematoma (SDH) is a condition when blood collects underneath the protective covering of the brain known as the dura. The dura is the outermost and strongest of the three protective layers of the brain. With subdural hematoma, veins (blood vessels) that are in the dura may tear and bleed. Blood collects within the dura, causing the dura to expand, push, and compress the brain. This compression (squeezing) of the brain can lead to serious medical problems.

What causes subdural hematoma?

Subdural hematoma may be caused by any of the following:

• A serious head injury. This causes an acute (sudden) subdural hematoma.
  
  
• Medicines that make the veins more likely to bleed, such as clot busters and blood thinners.
  
  
• Aging causes the brain to shrink. When the brain shrinks, it pulls on the dura, stretching the veins, making them more likely to bleed. In the elderly, symptoms may take several weeks to appear. This is called chronic (long-term) subdural hematoma.
  
  
• Medical conditions such as cancer, liver disease due to alcohol abuse, and blood vessel wall weakness.

What are the signs and symptoms of subdural hematoma?

• Body weakness that may happen quickly or slowly over time.
  
  
• Decreased level of alertness.
  
  
• Difficulty speaking or slurred speech.
  
  
• Fainting or loss of consciousness (passing out).
  
  
• Feeling nauseated (sick to the stomach) and vomiting (throwing up).
  
  
• Headache.
  
  
• Neck stiffness.
  
  
• Seizures (convulsions).

How is subdural hematoma diagnosed?

• CT scan: This test is also called a CAT scan. An x-ray and computer are used to take pictures of your skull and brain. You may be given dye, also called contrast, before the test. Tell the caregiver if you are allergic to dye, iodine, or seafood.
  
  
• MRI: This scan uses powerful magnets and a computer to take pictures of your brain. It will also take pictures of the blood vessels and structures in your head. You may be given dye, also called contrast, before the test. Tell caregivers if you are allergic to dye, iodine, or seafood. Remove all jewelry, and tell caregivers if you have any metal in or on your body. Metal can cause serious injury. Tell caregivers if you cannot lie still or are anxious or afraid of closed spaces.

How is subdural hematoma treated?

You may have one or more of the following treatments:

• Surgery: This is the only treatment that can remove the blood in the dura. Ask your caregiver for more information about surgery used to treat subdural hematoma.
  
  
• Medicines: If surgery cannot be done, you may receive the following medicines:
  
  
  • Diuretics: You may get diuretic medicine to help decrease swelling in your brain. This may help your brain get better blood flow.
    
    
  • Steroids: This medicine may be given to decrease inflammation.
    
    
  • Anticonvulsant medicine: This medicine is given to control seizures. Take this medicine exactly as directed.
  
  
• Bed rest: You may need to rest in bed if you have a small amount of blood in the dura. Caregivers may want to see you often to be sure there is no further bleeding.

Where can I find support and more information?

Having a subdural hematoma is a life-changing condition for you and your family. Accepting that you have a subdural hematoma is hard. You and those close to you may feel sad, anxious, and frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. You may also want to join a support group with other people who have had a subdural hematoma. Contact the following for more information:

• Brain Injury Association
  1608 Spring Hill Road
  Vienna , VA 22182
  Phone: 1- 703 - 761-0750
  Phone: 1- 800 - 444-6443
  Web Address: http://www.biausa.org
  

• National Headache Foundation
  820 N. Orleans, Suite 217
  Chicago , IL 60610
  Phone: 1- 888 - NHF-5552
  Web Address: http://www.headaches.org
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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