How to Treat Subdural Haematoma?

What is Subdural Hematoma?

A subdural hematoma (SDH) occurs when blood accumulates between the layers of tissue surrounding the brain, known as the dura mater. This accumulation of blood can exert pressure on the brain, resulting in various neurological symptoms. SDH can be acute, subacute, or chronic, depending on the time frame of symptom development. It is essentially a bleed inside the head, occurring within the skull but outside the brain tissue. The brain is safeguarded by three membrane layers, called meninges, situated between the bony skull and the brain tissue. These meninges serve the crucial function of covering and protecting the brain.

In the case of a subdural hematoma, a tear, typically in a vein, causes blood to leak into the space below the dura mater membrane layer. This space, known as the subdural space, is beneath the dura. The bleeding into this space is referred to as a subdural hemorrhage. Subdural hematoma is alternatively called subdural hemorrhage or intracranial hematoma. It is broadly categorized as a type of traumatic brain injury (TBI). The condition arises when a tear in a blood vessel leads to blood leakage, emphasizing the significance of understanding and addressing the underlying causes and symptoms associated with subdural hematoma.

Why Does Subdural Hematoma Occur?

Subdural hematomas typically result from head injuries that cause the tearing of blood vessels between the brain and its outermost covering. This tearing can occur due to trauma, falls, accidents, or even minor incidents, especially in older adults with more fragile blood vessels. Chronic subdural hematomas may also develop spontaneously in older individuals due to age-related brain atrophy, where blood vessels are more prone to tearing.

How is Subdural Hematoma Diagnosed?

Diagnosing subdural hematoma involves a thorough neurological examination and imaging studies. CT scans and MRI scans are commonly used to visualize the extent of bleeding and its impact on the brain. The severity of symptoms, such as headaches, confusion, and neurological deficits, helps determine the urgency of intervention.

Treatment Solutions for Subdural Hematoma:

Prompt and appropriate treatment is crucial for subdural hematoma to prevent further complications and reduce the risk of long-term damage. The choice of treatment depends on factors such as the size of the hematoma, the patient's overall health, and the severity of symptoms.

1. Observation: Small, asymptomatic hematomas may be observed without immediate intervention. Monitoring allows healthcare professionals to assess if the hematoma resolves on its own. 
2. Medication: Medications may be prescribed to manage symptoms such as pain and seizures. Controlling symptoms contributes to the overall comfort and well-being of the patient during recovery. 
3. Drainage or Surgery: Large or symptomatic hematomas may require surgical intervention to drain the accumulated blood. Surgery aims to alleviate pressure on the brain, preventing further neurological damage.
4. Burr Hole Surgery: A minimally invasive procedure involving drilling small holes to drain the hematoma. Burr hole surgery provides an effective way to evacuate blood and relieve pressure.
5. Craniotomy: A more extensive surgical procedure involving the removal of part of the skull to access and remove the hematoma. Craniotomy is performed for larger hematomas that require more intricate intervention.

Benefits of Treating Subdural Hematoma: 

1. Prevention of Neurological Damage: Early treatment prevents prolonged pressure on the brain, minimizing the risk of neurological deficits.
2. Symptom Relief: Effective treatment alleviates symptoms such as headaches, confusion, and seizures, enhancing the patient's comfort.
3. Prevention of Complications: Timely intervention reduces the risk of complications such as brain herniation or seizures associated with untreated hematomas.
4. Improved Quality of Life: Successful treatment enhances the overall quality of life by addressing symptoms and preventing long-term impairments.
5. Reduced Risk of Recurrence: Adequate management reduces the likelihood of recurrent subdural hematomas, especially in cases of chronic hematomas.