A subdural hematoma is a serious, and potentially life-threatening, head injury that occurs when blood collects between the brain's cover (known as the dura) and its surface. A subdural hematoma is not something you can diagnose at home, though you may suspect you have one based on symptoms.
Any head injury is a medical emergency that has the potential to become life-threatening. So if you have recently suffered a blow to the head, have signs of a stroke, or have experienced a change in consciousness or personality, don't delay seeking medical help.
Prompt medical assistance is the single best predictor of recovery from any head injury, including subdural hematomas. Without proper medical intervention, death can occur in just a few hours.
A subdural hematoma occurs when the tiny blood vessels within the brain's dura tear, causing blood to pool in the brain. The bleeding can quickly fill the brain, compressing parts of the brain, impeding brain function, leading to organ failure, and even causing death.
Doctors have identified two types of subdural hematomas. An acute subdural hematoma is one that results from a head injury, such as a car accident or a fall. A non-acute subdural hematoma may occur after a stroke, as the result of a brain lesion, or for no clear reason.
Elderly people and newborns are more vulnerable to this variety of subdural hematomas than adults. This is because the blood vessels in the brains of the elderly may already be stretched or shrinking, making them more vulnerable to tears. Infants are more vulnerable to head injuries, and the birth process may damage delicate blood vessels. Because their skulls have not yet fused, the effects of head trauma may also be more severe.
Any head injury, including relatively minor injuries, can lead to subdural hematomas, since such bleeding only requires damage to a single blood vessel. Some common causes of subdural hematomas include:
Subdural hematomas rarely occur for no apparent reason or without symptoms. So while it's easy to fear a subdural hematoma—particularly if you are the parent of a newborn or a caregiver for a senior—rest assured that the odds of suddenly dying, without warning, from a subdural hematoma are vanishingly slim.
Most people who experience a subdural hematoma have suffered a blow to the head or fall, so seek immediate medical attention if this happens to you. Some symptoms to watch for include:
Since babies can't report on their experiences to their parents, parents should monitor for the following signs:
When a person has other risk factors for a subdural hematoma, such as very young or old age or a recent head injury, it's particularly important to seek prompt medical assistance.
Doctors who suspect a subdural hematoma will ask about symptoms, as well as a recent history of falls, head trauma, or drugs that might interfere with blood clotting. To conclusively diagnose a subdural hematoma, the doctor will need to conduct a brain imaging scan.
There are two treatment goals when managing subdural hematomas: first, to stop the bleeding and save the patient's life, and second, to mitigate or reverse any damage the bleeding has caused. To stop the bleeding:
After the immediate danger has passed, the focus becomes restoring as much function as possible. Some subdural hematoma survivors suffer no lasting brain damage, but if you experience problems with functioning, a number of treatments are available: