(Extra-axial Haematoma; Subdural Haemorrhage; SDH)
A hematoma is a collection of blood. A subdural hematoma (SDH) happens in the space between the covering of brain (the dura) and the brain. It can put pressure on the brain.
SDH is most often caused by a head injury. This may be due to traumas such as car accidents, assault, and falls.
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This problem is more common in men, older adults, infants, toddlers, and people on blood-thinning medicines. Other things that may raise the risk are:
The blood may pool quickly or take some time to build up. This will affect how fast symptoms happen.
A person with an SDH may have:
- Changes in thinking or behavior
- Bruising around the head or eyes
- Vision problems
- Speech problems
- Loss of consciousness
The doctor will ask about symptoms and health history. A physical exam will be done.
Pictures may be taken of the brain and the structures around it. This can be done with:
The goal of treatment is to ease any pressure that is on the brain. How this is done will depend on how big and how severe the SDH is. It will also depend on the symptoms a person is having. Options are:
- Watching the injury for changes
- Medicines to ease brain swelling, such as steroids
- Surgery to ease pressure on the brain
This problem is often caused by a head injury. These can be hard to prevent.
- Fomchenko, E.I., Gilmore, E.J., et al. Management of Subdural Hematomas: Part I. Medical Management of Subdural Hematomas. Curr Treat Options Neurol. 2018; 20 (8): 28.
- Subdural hematoma. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/subdural-hematoma.
- Subdural haematoma. NHS website. Available at: https://www.nhs.uk/conditions/subdural-haematoma.
- Rimas Lukas, MD
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