St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Chronic subdural hematoma

    Subdural hemorrhage - chronic; Subdural hematoma - chronic; Subdural hygroma

    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.

    Causes

    A subdural hematoma develops when the tiny veins that run between the dura and surface of the brain (bridging veins) tear and leak blood. This is usually the result of a mild 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 the elderly 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 the elderly, even after a minor head injury. You or your family may not remember any injury that could explain it.

    Risks include:

    • Long term, heavy alcohol use
    • Long-term use of aspirin, anti-inflammatory drugs, such as ibuprofen, or blood thinning (anticoagulant) medication such as warfarin
    • Diseases associated with reduced blood clotting
    • Head injury
    • Old age

    Symptoms

    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:

    • Confusion or coma
    • Decreased memory
    • Difficulty speaking or swallowing
    • Difficulty walking
    • Drowsiness
    • Headache
    • Seizures
    • Weakness or numbness of arms, legs, face

    Exams and Tests

    Your health care provider will ask questions about your medical history. The physical exam will carefully check your brain and nervous system to check for problems with:

    • Balance
    • Coordination
    • Mental functions
    • Sensation
    • Strength
    • Walking

    Because the symptoms and signs are often subtle, if there is any suspicion of a hematoma, a head CT or head MRI scan will be done to further evaluate your symptoms.

    Treatment

    The goalof treatment isto control symptoms andreduce or prevent permanent damage to the brain. Anticonvulsant medications such as carbamazepine, lamotrigine or levetiracetam 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.

    Outlook (Prognosis)

    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.

    Some chronic subdural hematomas return after drainage, and more surgeries may be needed.

    Possible Complications

    • Permanent brain damage
    • Persistent symptoms
      • Anxiety
      • Confusion
      • Difficulty paying attention
      • Dizziness
      • Headache
      • Memory loss
    • Seizures

    When to Contact a Medical Professional

    Call your doctor or nurse immediatelyif you or someone else has symptoms of chronic subdural hematoma. For example, call if you see symptoms of confusion, weakness, or numbness weeks or months after a head injury in an older person.

    Take the person to the emergency room or call 911 if the person:

    • Has convulsions (seizures)
    • Is not alert (loses consciousness )

    Prevention

    Avoid head injuries by using seat belts, bicycle and motorcycle helmets, and hard hats when appropriate.

    References

    Stippler M. Trauma of the nervous system: craniocerebral trauma.In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 50B.

    Ling GSF. Traumatic brain injury and spinal cord injury. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 406.

    BACK TO TOP

          A Closer Look

            Talking to your MD

              Self Care

                Tests for Chronic subdural hematoma

                  Review Date: 8/28/2012

                  Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

                  The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
                  adam.com

                  A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


                  Back  |  Top
                  About Us
                  Contact Us
                  History
                  Mission
                  Locations & Directions
                  Quality Reports
                  Annual Reports
                  Honors & Awards
                  Community Health Needs
                  Assessment

                  Newsroom
                  Services
                  Brain & Spine
                  Cancer
                  Heart
                  Maternity
                  Orthopedics
                  Pulmonary
                  Sleep Medicine
                  Urgent Care
                  Women's Services
                  All Services
                  Patients & Visitors
                  Locations & Directions
                  Find a Physician
                  Tour St. Luke's
                  Patient & Visitor Information
                  Contact Us
                  Payment Options
                  Financial Assistance
                  Send a Card
                  Mammogram Appointments
                  Health Tools
                  My Personal Health
                  mystlukes
                  Spirit of Women
                  Health Information & Tools
                  Clinical Trials
                  Health Risk Assessments
                  Employer Programs -
                  Passport to Wellness

                  Classes & Events
                  Classes & Events
                  Spirit of Women
                  Donate & Volunteer
                  Giving Opportunities
                  Volunteer
                  Physicians & Employees
                  For Physicians
                  Remote Access
                  Medical Residency Information
                  Pharmacy Residency Information
                  Physician CPOE Training
                  Careers
                  Careers
                  St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
                  Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile