Acute (subacute) subdural hematoma

Alternative names:

acute/subacute subdural hematoma; acute/subacute subdural hemorrhage; epidural hematoma

Treatment:

Acute/subacute subdural hematoma is an emergency condition!

Treatment goals include lifesaving measures, control of symptoms, and minimizing or preventing permanent brain damage. Lifesaving measures may include support of breathing and/or circulation.

Medications prescribed vary according to the type and severity of symptoms and the extent of brain damage that occurs. Corticosteroid medications such as dexamethasone may be used to reduce inflammation and swelling of the brain (see corticosteroids - oral). Diuretics may also be used to reduce swelling. Anticonvulsant medications such as phenytoin may be used to control or prevent seizures.

Emergency or urgent surgery may be required to reduce pressure within the brain. This may involve drilling a small hole in the skull to relieve pressure and allow drainage of the hematoma. Large hematomas or solid blood clots may need to be removed through a larger opening in the skull (craniotomy).

Expectations (prognosis):

Acute subdural hematoma progresses rapidly. The condition has a high death rate, even with prompt treatment because of uncontrollable rapid increase in intracranial pressure.

Subacute subdural hematoma may result in death or in permanent brain damage if untreated or, in some cases, even if treated.

Symptoms such as seizures may persist for several months after treatment. Seizures may begin as late as 2 years after the injury.

In adults, most recovery occurs in the first 6 months, with some improvement over approximately 2 years. Children usually recover more quickly and completely than adults. Incomplete recovery is the result of permanent brain damage.

Complications:

• Permanent brain damage
• Seizures
• Brain herniation
• Normal pressure hydrocephalus
• Persistent symptoms such as memory loss, dizziness, headache, anxiety, and difficulty concentrating

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if symptoms of subdural hematoma occur!

Emergency symptoms (that may indicate complications) include:

• Seizures
• Difficulty breathing
• Eyes, pupils different size (one pupil enlarged)
• Weakness
• Paralysis - complete or partial (one or both sides of the body)
• Changes in sensation, any part of the body
• Difficulty speaking
• Difficulty swallowing
• Vision changes
• Eye pain

Update Date: 10/08/99
Updated by: adam.com editorial