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Acute Subdural Hematoma

Last updated Sept. 13, 2019

Approved by: Krish Tangella MD, MBA, FCAP

Acute Subdural Hematoma is a bleeding condition within the brain. It is also known as an Acute Subdural Hemorrhage.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Acute Intracranial Subdural Haematoma
  • Acute Subdural Hemorrhage

What is Acute Subdural Hematoma? (Definition/Background Information)

  • Acute Subdural Hematoma is a bleeding condition within the brain. It is also known as an Acute Subdural Hemorrhage.
  • The brain is made up of three layers that protect it from being damaged. These coverings are called dura, arachnoid, and pia matter. This 3-layered membrane covering tightly holds the brain, preventing it from unintended movements or from being affected by harmful substances.
  • In subdural hematoma, blood gets collected beneath the dura matter and cause severe harm. Elderly adults are very prone to the condition.
  • Generally, Acute Subdural Hematoma occurs secondary to a severe blow to the head. However, in older individuals, even a mild trauma can cause severe damage due to the fragility of their brain structures.
  • The common signs and symptoms of Acute Subdural Hematoma are severe headache, loss of consciousness, weakness or numbness of a body part, and speech or vision abnormalities.
  • The condition may lead to coma and death if it is not treated promptly.

Who gets Acute Subdural Hematoma? (Age and Sex Distribution)

  • Acute Subdural Hematoma commonly affects elderly adults. In this population, the brain is already slowly shrinking and the veins in the brain are loose and unstable. The elderly have such a fragile brain that there is an increased incidence of subdural hematoma among this population group, from a head injury. Also, the risk of falls are far greater in this age group, making them more vulnerable to the condition
  • Young children, who are physically active, or athletes in general are also prone to it, especially if appropriate safety measures to protect the head from being injured are not taken
  • This brain condition is equally seen among males and females. There is also no evidence to illustrate that Acute Subdural Hematoma is more prevalent in any particular racial or ethnic group

What are the Risk Factors for Acute Subdural Hematoma? (Predisposing Factors)

Risk factors associated with Acute Subdural Hematoma are:

  • Elderly individuals are more prone to Acute Subdural Hematoma
  • Physically active individuals, such as athletes (sportspersons), are also prone to this condition, secondary to a head trauma or injury

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Acute Subdural Hematoma? (Etiology)

  • Acute Subdural Hematoma generally occurs due to a severe blow or injury to the head
  • Research has demonstrated Acute Subdural Hematoma to be rated as one of the most serious conditions in comparison to the other head trauma associated conditions
  • The accumulation of blood in the brain causes serious damage to the function and structure of the brain, placing excess pressure on the surrounding tissues. In many cases, such incidents can progress to a very severe form, leading to death
  • The older populations are typically affected more by this condition. A blow to the head may not immediately give rise to any signs and symptoms; it may remain silent for several weeks
  • Since the blood vessels are normally more loose and elongated in the elderly, the elderly are likely to develop this condition even with a mild trauma to the head

What are the Signs and Symptoms of Acute Subdural Hematoma?

The signs and symptoms associated with Acute Subdural Hematoma include:

  • Difficulty with speech, visual defects
  • Uncontrolled movements
  • Throbbing headaches
  • Lack of awareness, loss of sensation
  • Weak and tired, fatigue
  • Multiple seizure-like activities
  • History of falls/brain injury

How is Acute Subdural Hematoma Diagnosed?

A diagnosis of Acute Subdural Hematoma may include:

  • A complete evaluation of medical history along with a thorough physical exam
  • Any history of falls is very important. The physician will also seek to find symptoms, such as the presence of severe headache, vision-related defects, weakness of power, and numbness, following an injury to the head
  • CT and MRI brain scans may be performed to check for the presence of bleeding in the brain
  • Cerebral angiogram is a test done to assess the status of blood vessels in the brain
  • Cerebrospinal fluid (CSF) examination for the presence of blood

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Acute Subdural Hematoma?

The possible complications of Acute Subdural Hematoma include:

  • Loss of consciousness, intense headache
  • Muscle spasms
  • Paralysis of the body
  • Loss of sensation

Severe cases of Acute Subdural Hematoma could lead to coma and death.

How is Acute Subdural Hematoma Treated?

Acute Subdural Hematoma is a serious condition requiring immediate medical attention.

  • A procedure known as craniotomy may be performed. During this surgical procedure, several holes are made in the cranium (skull) to release the pressure
  • In addition to this, medications to thin the blood, such as aspirin, may be administered to avoid formation of clots that can spontaneously result in stroke
  • Medications may be also prescribed for pain and to control inflammation within the brain tissue

How can Acute Subdural Hematoma be Prevented?

Acute Subdural Hematoma can be prevented if proper safety precautions are followed.

  • In elderly adults, falls may be prevented by the use of walker or a cane that can help provide support and balance
  • Young individuals who participate in physical (sports) activities are also prone to head injuries. In such groups, ensuring the use of a helmet or other safety gear can help prevent the occurrence of Acute Subdural Hematoma

What is the Prognosis of Acute Subdural Hematoma? (Outcomes/Resolutions)

  • The prognosis of Acute Subdural Hematoma varies depending on the severity of the trauma to the head and the speed at which appropriate treatment was provided
  • The outcome also depends on the location in the head, where the injury took place, and how much blood accumulated in the region

Additional and Relevant Useful Information for Acute Subdural Hematoma:

According to current studies, it has been documented that Acute Subdural Hematoma has a high death rate incidence.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 17, 2015
Last updated: Sept. 13, 2019