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What is a Chronic Subdural Hematoma?

A Chronic Subdural Hematoma is a serious condition where blood collects between the brain's surface and its outer covering, often due to head injury. Symptoms may develop slowly and can include headaches, confusion, and weakness. Understanding this condition is crucial for timely intervention. How does this impact long-term health, and what treatments exist? Explore with us as we examine the intricacies.
K. Willis
K. Willis

A subdural hematoma is an accumulation of blood beneath the dura mater, which is the outer covering of the brain. This condition occurs when the bridging veins, which run between the surface of the brain and the dura mater, begin to leak or bleed, often after they have been stretched or excessive force has been exerted on them. A chronic subdural hematoma indicates that the blood began to collect more than 21 days before. The other most common type of subdural hematoma is an acute subdural hematoma in which the bleeding first began less than 72 hours previous.

A patient with a chronic subdural hematoma may present with a variety of symptoms which can vary with each patient, influenced by factors such as age, life style, indications of recent trauma, and medical history. Many symptoms of chromic subdural hematomas are very similar to those in other conditions. Symptoms may include anxiety, depression, memory loss, and confusion, often mimicking signs of dementia. Seizures and persistent headaches are also common.

An MRI scan of the head may be used to help diagnose a chronic subdural hematoma.
An MRI scan of the head may be used to help diagnose a chronic subdural hematoma.

Many symptoms can cause additional complications. For example, someone with this condition may have difficulty swallowing, which may cause choking and aspiration. Weakness in the limbs can result in poor mobility and increase the risk of falls and further injury. Confusion and an altered mental state can result in poor judgment, increasing the risk of injury and poor decision making.

Confusion and memory loss are possible signs of a subdural hematoma.
Confusion and memory loss are possible signs of a subdural hematoma.

A chronic subdural hematoma requires surgical intervention and will not heal unaided, as the collection of blood has nowhere to go. The procedure to treat this condition is known as craniotomy. The procedure involves creating a small opening in the skull and draining off the accumulated blood. Both the surgery and the untreated condition carry risk of permanent brain damage, but the risk is far greater in cases where the chronic subdural hematoma is not treated.

People suffering from chronic subdural hematoma may have difficulty swallowing, which may lead to choking.
People suffering from chronic subdural hematoma may have difficulty swallowing, which may lead to choking.

Often caused by head trauma, chronic subdural hematoma is more likely to occur in people over 60. As part of the natural aging process, the brain may shrink or atrophy, meaning that the surface of the brain grows smaller, leaving a greater gap between the dura mater and the brain surface. The bridging veins are then stretched tight, with greater force exerted on them, posing a greater threat of leakage and hematoma formation with even minor head trauma.

People taking anti-coagulant medications are at increased risk of chronic subdural hematoma because the blood is unable to clot as effectively if bridging veins do begin to leak. In infants, subdural hematoma is often caused by trauma or abuse such as shaken baby syndrome. Other people at a higher risk of developing a chronic subdural hematoma include those with long-term alcohol and substance abuse.

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    • An MRI scan of the head may be used to help diagnose a chronic subdural hematoma.
      By: Marcin Sadlowski
      An MRI scan of the head may be used to help diagnose a chronic subdural hematoma.
    • Confusion and memory loss are possible signs of a subdural hematoma.
      By: chuugo
      Confusion and memory loss are possible signs of a subdural hematoma.
    • People suffering from chronic subdural hematoma may have difficulty swallowing, which may lead to choking.
      By: nebari
      People suffering from chronic subdural hematoma may have difficulty swallowing, which may lead to choking.