Subdural hematoma (bleeding in the brain)

Head | Neurology | Subdural hematoma (bleeding in the brain) (Disease)


Subdural hematoma (HSD) is a collection of blood that occurs between cranial dura and arachnoid (two of the three coverings of the central nervous system). It can occur at any age from infants to elderly, most commonly from an injury. Thus 25% of patients with head trauma will develop a subdural hematoma.

Hematoma size depends on the amount of bleeding and the development of cerebral edema will help stop bleeding. Blood is spilled on large areas of the brain, which favors the appearance of intracranial hypertension due to brain compression. HSD infarction occurs in the first 3 days after injury, is composed of clots of reddish gelatinous consistency and less liquid blood. HSD subacute occurs between 3-21 days after injury and consists of gelatinous clots and an increased amount of blood.

Chronic HSD appears after 3 weeks of injury and consists of a capsule containing blood. Symptoms collection will depend on the intensity and severity of brain lesions. The clinical picture that appears when an acute HSD is: the existence of a cerebral trauma with altered consciousness immediately. Appears to be a brief loss of consciousness or, in severe cases, a profound impairment of consciousness.

Period of remission is usually short (few hours) may be masked by persistent headache, dizziness, impaired general condition. In forms supraacute (coma for 2-4 hours) period of remission may be absent, occurring rapidly worsening.

Causes and Risk factors

The most frequently cerebral trauma is responsible for the appearance of a subdural hematoma, such a lesion occurring in road accidents, assaults or falls from height. Subdural hematoma occurrence can be caused by: anticoagulant medications: heparin, warfarin; coagulopathy; after surgeries; intracranial aneurysms, arteriovenous malformations; Shaken baby syndrome.

The formation of blood collection can be explained by: bleeding fo produced in the injured as a result of trauma; rupture of a cerebral cortex affecting the hematoma and subdural space overflows; rupture of the cerebral vascular malformation, or aneurysm;In the coagulopathy.

Diagnosis and Treatment

A subdural hematoma is an emergency condition. Emergency surgery may be needed to reduce pressure within the brain. This may involve drilling a small hole in the skull, which allows blood to drain and relieves pressure on the brain. Large hematomas or solid blood clots may need to be removed through a procedure called a craniotomy, which creates a larger opening in the skull.

Medicines used to treat a subdural hematoma depend on the type of subdural hematoma, the severity of symptoms, and how much brain damage has occurred. Diuretics and corticosteroids may be used to reduce swelling. Anticonvulsion medications, such as phenytoin, may be used to control or prevent seizures. ...

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