A subdural hematoma, also known as a subdural hemorrhage, is a collection of blood that builds up between the inside of the skull and the brain tissue. It happens when a blood vessel bursts or tears and blood builds up under the dura mater, which is the outermost layer of tissue that surrounds the brain. The buildup of blood puts pressure on the brain.
Most subdural hematomas occur from some form of a head injury. In acute cases, bleeding occurs immediately upon impact.
Chronic subdural hematomas develop slowly, over days or weeks. This is commonly seen in elderly patients, as the brain shrinks over time and stretches the veins to the breaking point in the process. The chronic form also can be seen in car accident injuries where a mild — or even severe — blow to the head can lead to a delayed brain bleed.
Our expert team of neurosurgeons at Apex Spine and Neurosurgery in Roswell and Bethlehem, Georgia, specializes in the diagnosis and treatment of motor vehicle accident injuries affecting the head and spine. This includes caring for patients with subdural hematomas.
Chronic subdural hematomas can lead to delayed headaches and neurological deficits if not caught and treated. That’s why it’s important to recognize the signs so you can seek immediate medical help.
Subdural hematoma basics
Subdural hematomas affect up to 25% of people who sustain head injuries, and they can be a serious event. If the bleed is slow, the body may be able to absorb the pooled blood. If the bleed is acute and severe, the buildup of blood puts pressure on the brain, leading to breathing difficulties, paralysis, and even death.
Because there’s no way to tell how severe the bleed is without imaging tests, if you sustain a blow to the head, consider it serious and get it checked out as soon as possible.
Signs of a chronic subdural hematoma
A hematoma is a type of traumatic brain injury (TBI), so the symptoms of the two conditions overlap somewhat.
Signs of a chronic subdural hematoma include:
- Nausea and vomiting
- Vision problems
- Speech issues
- Swallowing difficulties
- Impaired memory
- Walking difficulties
- Numbness of the face, arms, or legs
- Weakness or paralysis
The exact symptoms depend on where the hematoma is located and how large it is, and some symptoms are more common than others. Up to 80% of people with chronic subdural hematomas get headaches.
Sometimes people don’t develop symptoms immediately following a head injury, but they may show up later, so you should always get a head injury checked out. Chronic subdural hematomas can be mistaken for other conditions, such as a stroke, a brain tumor, or even dementia, so diagnosis is key.
Diagnosing and treating chronic subdural hematomas
When you come in to our office, in addition to performing a rigorous physical and neurological examination, we rely on imaging studies, such as magnetic resonance imaging (MRI) and computed tomography (CT) to provide a more accurate diagnosis.
Larger chronic subdural hematomas may be treated surgically. In some cases, the team at Apex Spine and Neurosurgery performs an emergency craniotomy to remove the pooled blood to ease the pressure on the brain. The surgeon drills one or more holes in the skull to allow the blood to drain, thereby relieving pressure on the brain tissue.
Additional surgery may be required to remove any blood clots, if present. Usually, the doctor leaves a drain in place for several days to allow the blood to drain completely.
If the hematoma causes few or no symptoms and the bleed is small enough, surgery isn’t required. It may be that bed rest, medications, and observation are all that’s needed. Your body can absorb a small amount of blood over time, usually over the course of a few months. We may order imaging tests to ensure the hematoma is healing.
If you’ve been in a car accident and have suffered a blow to the head, consider it an emergency and seek medical help, even if you’re not showing any immediate symptoms. Give Apex Spine and Neurosurgery a call at either of our offices to schedule an appointment, or book online with us today.