Chronic Subdural HematomaSymptoms, Doctors, Treatments, Advances & More
Learn About Chronic Subdural Hematoma
A chronic subdural hematoma is an "old" collection of blood and blood breakdown products between the surface of the brain and its outermost covering (the dura). The chronic phase of a subdural hematoma begins several weeks after the first bleeding.
Subdural hemorrhage - chronic; Subdural hematoma - chronic; Subdural hygroma
A subdural hematoma develops when bridging veins tear and leak blood. These are the tiny veins that run between the dura and surface of the brain. This is usually the result of a head injury.
A collection of blood then forms over the surface of the brain. In a chronic subdural collection, blood leaks from the veins slowly over time, or a fast hemorrhage is left to clear up on its own.
A subdural hematoma is more common in older adults because of normal brain shrinkage that occurs with aging. This shrinkage stretches and weakens the bridging veins. These veins are more likely to break in older adults, even after a minor head injury. You or your family may not remember any injury that might have caused a subdural hematoma.
Risks include:
- Long-term heavy alcohol use
- Long-term use of aspirin, anti-inflammatory medicines such as ibuprofen, or blood thinning (anticoagulant) medicine such as warfarin
- Diseases that lead to reduced blood clotting
- Head injury
- Old age
In some cases, there may be no symptoms. However, depending on the size of the hematoma and where it presses on the brain, any of the following symptoms may occur:
- Drowsiness, confusion, or coma
- Decreased memory
- Problem speaking or swallowing
- Problems with balance or walking
- Headache
- Seizures or loss of consciousness
- Weakness or numbness of arms, legs, face
- Nausea and vomiting
- Vision problems
- Behavioral changes or psychosis
The goal of treatment is to control symptoms and reduce or prevent permanent damage to the brain. Medicines may be used to control or prevent seizures.
Surgery may be needed. This may include drilling small holes in the skull to relieve pressure and allow blood and fluids to be drained. Large hematomas or solid blood clots may need to be removed through a larger opening in the skull (craniotomy).
Hematomas that do not cause symptoms may not require treatment. Chronic subdural hematomas often come back after being drained. Therefore, it is sometimes better to leave them alone unless they are causing symptoms.
Beth Israel Deaconess Medical Center
Christopher Ogilvy is a Neurosurgery provider in Boston, Massachusetts. Dr. Ogilvy has been practicing medicine for over 42 years and is rated as an Elite provider by MediFind in the treatment of Chronic Subdural Hematoma. His top areas of expertise are Brain Aneurysm, Arteriovenous Malformation, Chronic Subdural Hematoma, Craniectomy, and Endovascular Embolization.
Beth Israel Deaconess Medical Center
Martina Stippler is a Neurosurgery provider in Boston, Massachusetts. Dr. Stippler is rated as an Elite provider by MediFind in the treatment of Chronic Subdural Hematoma. Her top areas of expertise are Subdural Hematoma, Chronic Subdural Hematoma, Pituitary Tumor, Balloon Sinuplasty, and Laminectomy.
Texas Health Neurosurgery And Spine Specialists
"Dr. Olaide Ajayi is board-certified by the American Board of Neurological Surgeons and is a Fellow of the American Association of Neurological Surgeons. He is the Medical Director of Spine Surgery at Texas Health Harris Methodist Hospital in Fort Worth.Dr. Ajayi completed his Neurosurgery Residency as well as a Complex and Minimally Invasive Spine Fellowship at Loma Linda University Medical Center in Southern California. He also received his Medical Doctorate from the same institution. He has authored and contributed to many peer review publications on various neurosurgical and spine related topics.His areas of special focus include the surgical management of degenerative scoliosis, spine tumors, spine trauma, complex and minimally invasive spine surgery, and degenerative spine disease. Dr. Ajayi takes a comprehensive approach in the management of spinal disease, utilizing conservative treatment options when feasible, as well as minimally invasive and complex reconstructive approaches when necessary.Dr. Ajayi is a member of the North American Spine Society (NASS), American Association of Neurological Surgeons (AANS), Congress of Neurological Surgeons (CNS) and AANS/CNS Joint Spine Section.WATCH NOW:</h5>Patient Testimonial: North Texas Neurosurgical & Spine Center (Dr. Ajayi)</a>". Dr. Ajayi is rated as a Distinguished provider by MediFind in the treatment of Chronic Subdural Hematoma. His top areas of expertise are Subdural Hematoma, Chronic Subdural Hematoma, Delirium, Microdiscectomy, and Cervical Disc Surgery.
Chronic subdural hematomas that cause symptoms usually do not heal on their own over time. They often require surgery, especially when there are neurologic problems, seizures, or chronic headaches.
Complications may include:
- Permanent brain damage
- Persistent symptoms, such as anxiety, confusion, difficulty paying attention, dizziness, headache, and memory loss
- Seizures
Contact your provider right away if you or a family member has symptoms of chronic subdural hematoma. For example, if you see symptoms of confusion, weakness, or numbness weeks or months after a head injury in an older adult, contact the provider right away.
Take the person to the emergency room or call 911 or the local emergency number if the person:
- Has seizures
- Is not alert (loses consciousness)
Avoid head injuries by using seat belts, bicycle and motorcycle helmets, and hard hats when appropriate.
Summary: Chronic subdural hematoma (CSDH) is a frequent condition in neurosurgery, leading to fluid accumulation between the meninges, brain compression, neurological dysfunction, and potentially herniation. The efficacy of treatments and their long-term outcomes remain uncertain, with no established standard. Notably, neuroendoscopy-assisted hematoma evacuation, in contrast to burr-hole drainage, enables ...
Summary: Chronic subdural hematomas (CSH) are collections of blood in the subdural space. CSH are becoming the most common cranial neurosurgical condition among adults, and a significant public health problem, due to an increasing use of anticoagulant and antiplatelet medication in an ageing population. Symptomatic CSH, or CSH with a significant mass effect, are treated surgically. However, recurrences are...
Published Date: June 13, 2024
Published By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Kolias AG, Taisic T, Chari A, Hutchinson PJ, Santarius T. Medical and surgical management of chronic subdural hematomas. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 47.
Papa L, Goldberg SA. Head trauma. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 33.
Stippler M, Mahavadi A. Craniocerebral trauma. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 62.