What is a subdural hematoma?

A subdural hematoma is a type of bleeding that happens between the brain and its outer protective covering. This blood buildup can create pressure inside the skull, potentially affecting how the brain functions.

Most cases are linked to a head injury, but symptoms don’t always appear right away.

Other common causes and risk factors include:

• Aging, which can make blood vessels more fragile
• Use of blood-thinning medications
• Frequent alcohol use
• Previous head trauma
• Repeated impacts to the head

Symptoms

Symptoms can vary depending on how quickly the bleeding occurs. Some people feel effects right away, while others notice changes days or even weeks later.

Common symptoms include:

• Persistent headache
• Confusion or trouble thinking clearly
• Dizziness or balance problems
• Nausea or vomiting
• Feeling very sleepy or having a hard time waking
• Weakness or numbness, often on one side
• Speech or vision changes
• Seizures
• Loss of consciousness

How is it diagnosed?

A subdural hematoma is often treated as an emergency. Your provider will begin with a physical and neurological exam to check your reflexes, coordination, and mental alertness.

Imaging tests are essential to confirm the diagnosis. A CT scan is usually the first step, while an MRI may be used for a more detailed view. Blood tests may also be done to check how well your blood clots.

How is it treated?

Treatment depends on the size of the bleed and the severity of the symptoms.

For smaller hematomas, careful monitoring in the hospital may be all that’s needed. Your care team may use repeat imaging and medications to manage symptoms.

If pressure on the brain is significant, surgery may be required. This can include:

• Draining the blood through small openings in the skull
• Removing the clot through a larger surgical procedure

Your provider may also adjust or reverse blood-thinning medications and monitor pressure inside the skull during recovery.

Early treatment is important and can improve outcomes. Recovery time varies based on the severity of the condition and how quickly care is received.