Acute Subdural Hematoma

Bleeding between the brain membranes occurring shortly after head trauma; requires emergency evaluation.

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1Overview

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What is this Condition?

Acute subdural hematoma is bleeding that accumulates in the space between the dura mater and the arachnoid membrane, usually within the first days following severe head trauma. The bleeding usually results from rupture of small vessels on the brain surface. This is a serious condition requiring rapid evaluation because bleeding can cause damage and swelling to the surrounding brain tissue and surrounding structures. In elderly patients with brain atrophy and those taking anticoagulant medications, it can develop from minor trauma. As the pressure from accumulated blood increases, symptoms such as altered consciousness, weakness on one side of the body, and headache may develop. Treatment is planned based on the size of the hemorrhage, the pressure it exerts on the brain, and the patient's level of consciousness; some patients require close monitoring while others require emergency surgery.

Symptoms

Headache

Altered consciousness, drowsiness, or changes in mental status

Weakness on one side of the body

Gait disturbance

Speech difficulty

Seizures

Diagnosis Methods

The first and most important examination is brain CT scan; the hemorrhage appears as a crescent-shaped image following the brain surface. CT scan shows whether the bleeding is recent or older, how much pressure it exerts on the brain, and whether the midline is shifted. In some cases, particularly to distinguish the age of hemorrhage or assess its effect on brain tissue, MRI imaging may be added. After diagnosis, the patient's level of consciousness and neurological findings are closely monitored.

Treatment Methods

Treatment is determined based on the size of the hemorrhage and the patient's condition. If the hemorrhage is small, if brain pressure is low, and if the patient is alert, close monitoring in the intensive care unit with repeated examinations and follow-up CT scans may be preferred; anticoagulant effects may be reversed if needed during this period. If the hemorrhage is large, if it causes significant pressure on the brain, or if consciousness is altered, emergency surgery is performed to evacuate the blood. In cases of significant cerebral edema, a bone flap is temporarily removed to relieve brain pressure; this bone flap is replaced in the following weeks. The decision is made individually for each patient through team evaluation.

Emergency surgical evacuation of blood

Temporary bone flap removal to reduce swelling and later replacement

Close monitoring in intensive care and follow-up CT scans in appropriate patients

Reversal of anticoagulant medication effects

Treatment Path

Related Treatments

The procedures and interventions most commonly explored with this condition.

4 links

Decompressive Craniectomy (Unilateral)

Decompressive Craniectomy (Unilateral) procedure

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Subdural hematom drenajı, burr hole ile, tek taraflı

Subdural hematom drenajı, burr hole ile, tek taraflı procedure

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Epidural hematom drenajı, kranyotomi ile

Epidural hematom drenajı, kranyotomi ile procedure

Open treatment detail

Cranioplasty (with Autogenous Graft)

Cranioplasty (with Autogenous Graft) procedure

Open treatment detail

References

Greenberg MS. Handbook of Neurosurgery. 10th ed. Thieme; 2023.
Winn HR, ed. Youmans and Winn Neurological Surgery. 6th ed. Elsevier; 2011.
Quiñones-Hinojosa A, ed. Schmidek and Sweet Operative Neurosurgical Techniques. 7th ed. Elsevier; 2021.

This content is for informational purposes and based on academic sources; consult your physician for diagnosis and treatment.

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Acute Subdural Hematoma

Traumatic Brain Injuries

1Overview

What is this Condition?

Symptoms

Diagnosis Methods

Treatment Methods

Related Treatments

Decompressive Craniectomy (Unilateral)

Subdural hematom drenajı, burr hole ile, tek taraflı

Epidural hematom drenajı, kranyotomi ile

Cranioplasty (with Autogenous Graft)

References

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Related Treatments

Decompressive Craniectomy (Unilateral)

Subdural hematom drenajı, burr hole ile, tek taraflı

Epidural hematom drenajı, kranyotomi ile

Cranioplasty (with Autogenous Graft)

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