Chronic subdural hematoma

Alternative names:

subdural hematoma, chronic; subdural hemorrhage, chronic

Treatment:

Treatment goals include controlling symptoms and minimizing or preventing permanent damage to the brain.

Medications used will vary according to the type and severity of symptoms and brain damage. Corticosteroid medications may be used to reduce inflammation and swelling of the brain. Diuretics may also be used to reduce swelling. Anticonvulsant medications such as phenytoin may be used to control or prevent seizures.

Surgery may be required. This may include drilling a small hole in the skull to relieve pressure and allow blood to be drained. Large hematomas or solid blood clots may need to be removed through a larger opening in the skull (craniotomy).

Expectations (prognosis):

Chronic subdural hematoma may result in death or permanent brain injury if untreated or, occasionally, even if treated. Symptoms such as seizures may persist for several months even after treatment. Seizures may begin as much 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 brain damage.

Complications:

• permanent brain damage
• persistent symptoms
  • loss of memory
  • dizziness
  • headache
  • anxiety
  • difficulty maintaining attention

• seizures
• uncal herniation
• normal pressure hydrocephalus

Calling your health care provider:

Because of the risk of permanent brain damage, a health care provider should be called promptly if symptoms of chronic subdural hematoma appear.

Go to the emergency room or call the local emergency number (such as 911) if emergency symptoms develop, including convulsions/seizures, decreased responsiveness, loss of consciousness, enlarged pupils, and uneven pupil size.