In chronic subdural hematomas (CSDH), blood accumulates between the outermost covering (dura mater) and the arachnoid membrane of the brain. This condition has a number of causes, symptoms, diagnosis, treatment, and prevention measures.
The exact cause of chronic subdural hematoma is often related to minor head trauma or injury, especially in older adults. However, it can also occur spontaneously without any apparent injury. In addition to advanced age, alcoholism, blood-thinning medication (anticoagulants), and certain medical conditions such as epilepsy or coagulopathies, CSDH is associated with risk factors.
It is common for chronic subdural hematomas to develop gradually over time and to vary from individual to individual. Common symptoms include:
Headache, often worsening over time
Mental confusion or changes
Feeling dizzy or lightheaded
Nausea and vomiting
One side of the body is weak or numb
Speaking or understanding speech with difficulty
Seizures
Double vision or blurry vision are examples of visual disturbances
Consciousness loss
A chronic subdural hematoma is usually diagnosed based on a combination of medical history, physical examination, and imaging studies. Diagnostic testing may include:
For the diagnosis of CSDH, computed tomography (CT) scans of the head are the preferred imaging modality. They can show the hematoma's size, location, and presence.
In cases where the diagnosis is unclear or additional information is needed, magnetic resonance imaging (MRI) may provide detailed images of the brain and surrounding structures.
Examining cognitive function, motor skills, reflexes, and sensory perception may be part of a neurological examination.
Chronic subdural hematomas are treated based on factors such as the size and location of the hematoma and an individual's overall health and symptoms. Treatment options include:
In individuals with stable symptoms and no signs of neurological decline, small, asymptomatic hematomas may be monitored closely without immediate intervention.
In order to relieve pressure on the brain and remove accumulated blood, surgical drainage may be necessary for symptomatic or large hematomas. The procedure may involve drilling a small hole in the skull (burr hole) or performing a craniotomy to access the hematoma and evacuate the blood.
To reduce inflammation, prevent seizures, and manage symptoms, medications such as corticosteroids or antiepileptic drugs may be prescribed.
The development of chronic subdural hematomas is not always preventable, particularly in cases of accidental head trauma. However, taking steps to reduce the risk of head trauma can help minimize the chances of developing CSDH.
Sports and recreational activities should be conducted with appropriate safety gear, such as helmets for cycling and skiing.
It is important to avoid excessive alcohol consumption, which can increase the risk of falling and accidents.
It is important to use caution when taking medications that increase bleeding risk or interfere with blood clotting, especially for older adults and those with underlying medical conditions.
It is important to seek medical attention for head injuries or trauma as soon as possible, even if the symptoms seem mild at first.
Subdural hematomas, or chronic subdural hematomas, are conditions that result from the accumulation of blood between the brain's outermost covering and the arachnoid membrane. In order to manage CSDH and minimize complications, early diagnosis, proper treatment, and preventive measures are essential. The symptoms of a subdural hematoma should be evaluated and managed promptly by a physician if you or someone you know experiences them.
