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.
UPMC Neurological Institute - Presbyterian
David Okonkwo is a Neurosurgery provider in Pittsburgh, Pennsylvania. Dr. Okonkwo is rated as a Distinguished provider by MediFind in the treatment of Chronic Subdural Hematoma. His top areas of expertise are Subdural Hematoma, Scoliosis, Chronic Subdural Hematoma, Gastrostomy, and Microdiscectomy. Dr. Okonkwo is currently accepting new patients.
Aurora Neuroscience Innovation
David Straus is a Neurosurgery provider in Milwaukee, Wisconsin. Dr. Straus is rated as a Distinguished provider by MediFind in the treatment of Chronic Subdural Hematoma. His top areas of expertise are Meningioma, Pituitary Tumor, Subdural Hematoma, Gastrostomy, and Awake Craniotomy.
Advocate Medical Group Neurosurgery
Jerrel Boyer is a Neurosurgery provider in Chicago, Illinois. Dr. Boyer is rated as an Advanced provider by MediFind in the treatment of Chronic Subdural Hematoma. His top areas of expertise are Stroke, Delirium, Apoplexy, Gastrostomy, and Awake Craniotomy.
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: This study is an open label randomized controlled trial. Patients with a symptomatic Chronic Subdural Hematoma (CSDH) confirmed on radiological imaging, planned for surgery, age over 18, free from other intracranial pathologies and no previous intracranial surgery, will be recruited at time of admission. Patients eligible for inclusion will be randomized to receive treatment with Tranexamic acid (...
Summary: Chronic subdural hematoma (CSDH) is a common disease. The main treatment is neurosurgical evacuation and subsequent hematoma drainage. However, consensus on the optimal drain placement site, and whether the drainage should be active or passive, is lacking. The aim of the current study is to test the hypothesis that 24 hours active subperiosteal drainage is non-inferior to 24 hours passive subdural...
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.