Chronic Subdural Hematoma: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Chronic Subdural Hematoma?
A neurosurgeon (a surgeon who operates on the brain) and a neurologist (a doctor who treats brain and nerve problems) often treat chronic subdural hematoma. Surgery may be needed. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is chronic subdural hematoma?
A chronic subdural hematoma is an old collection of blood and blood breakdown products. It sits between the surface of the brain and its outermost covering, called the dura. The chronic phase starts several weeks after the first bleeding. In a chronic one, blood leaks slowly from the veins over time. It can also start as a fast bleed that is left to clear up on its own.
A chronic subdural hematoma is more often seen in older adults.
Symptoms
In some cases, there may be no symptoms. Symptoms depend on the size of the hematoma and where it presses on the brain. They may include:
- Headache
- Drowsiness or confusion
- Decreased memory
- Problems speaking or swallowing
- Problems with balance or walking
- Weakness or numbness of the arms, legs, or face
- Seizures or loss of consciousness
- Nausea and vomiting
- Vision problems
- Behavioral changes
Some people have symptoms that do not go away. These include anxiety, confusion, trouble paying attention, dizziness, headache, and memory loss.
Causes and who gets it
A subdural hematoma develops when bridging veins tear and leak blood. These are the tiny veins that run between the dura and the surface of the brain. This is usually the result of a head injury. Some subdural hematomas occur without cause.
A subdural hematoma is more common in older adults because the brain shrinks with age. This shrinkage stretches and weakens the bridging veins. In older adults, these veins break more easily, even after a minor head injury. You or your family may not remember an injury that caused it.
Risks include:
- Long-term heavy alcohol use
- Long-term use of aspirin, ibuprofen, or blood thinners such as warfarin
- Diseases that lead to reduced blood clotting
- Head injury
- Old age
Avoid head injuries by using seat belts, bicycle and motorcycle helmets, and hard hats when appropriate.
How doctors diagnose it
Your health care provider will ask about your medical history. The exam includes a careful check of your brain and nervous system. If there is any suspicion of a hematoma, an imaging test, such as a CT or MRI scan, will be done.
Treatment
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 clots may need to be removed through a bigger opening in the skull, called a 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.
Chronic subdural hematomas that cause symptoms usually do not heal on their own. They often require surgery, especially when there are seizures or chronic headaches. Symptoms often go away after the blood collection is drained.
When to see a doctor
Contact your provider right away if you or a family member has symptoms of chronic subdural hematoma. Contact the provider right away if an older adult has numbness weeks or months after a head injury. Older adults with memory problems or mental decline should also get care, even without a known injury.
Call 911 or go to the emergency room if the person has a seizure, is not alert, is newly confused, has sudden weakness, or has trouble speaking. After a head injury, call 911 or go to an emergency room. Do not delay.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can ask about your medical history and check your brain and nervous system. If a hematoma is suspected, an imaging test will be done.
Common questions
Is a chronic subdural hematoma an emergency?
It can be. Call 911 if the person has a seizure, is not alert, is newly confused, has sudden weakness, or has trouble speaking. Otherwise, contact your provider right away if you or a family member has symptoms.
Does a chronic subdural hematoma go away on its own?
Usually not, if it causes symptoms. Hematomas that do not cause symptoms may not require treatment.
Can a chronic subdural hematoma come back?
Yes, chronic subdural hematomas often come back after being drained. Sometimes it is better to leave them alone unless they cause symptoms.
Who is more likely to get a chronic subdural hematoma?
Older adults are more likely to get one.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
