Subdural Hematoma

By M. Chris Wolf, PH.D.

What is a subdural hematoma? Hematoma is a general clinical term for an injury, which breaks blood vessels but does not breach a surrounding tissue. The result is commonly referred to as a bruise. Just beneath the skin, a short bleed pools before the injured vessels clot, leaving the area dark with coagulated blood, and typically somewhat swollen and sensitive to touch. It can be unsightly and uncomfortable, but the skin cells and capillaries are usually quick to repair. In contrast, the same type of injury to the brain and/or its surrounding tissues can be catastrophic.

It makes sense that humans would have evolved complex systems to protect the organ on which they consciously rely upon for all experience with the human world. Because of its sensitivity as well as its obviously vital role in anatomical function, the brain is particularly at risk of being damaged seriously and permanently by such injuries. Although a thicker or more solid skull could guard against fractures, the brain would still be subject to trauma from internal impact with the skull itself; so the brain essentially floats, suspended within layers of cerebrospinal fluid and protective tissue - the above mentioned meninges, the dura mater, arachnoid, and pia mater.


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When an injury or systemic pathology results in internal bleeding between the outer, rigid dura mater and fibrous arachnoid, the injury is known as asubdural hematoma. The channels carrying blood from the brain to outside of the skull are torn, most commonly because of a concussive trauma. The space in between fills up with blood, and with nowhere to go to escape the skull, it swells the meninges space and puts pressure on the brain. Symptoms of this injury include a strong headache and confusion. If the building pressure is not relieved, it damages neurons and potentially brain death.

To reduce pressure intracranial pressure, it is often necessary to drill a small hole in the skull to allow blood to drain. If a large amount of blood pools and clots, it may be necessary to surgically remove the coagulated blood in a procedure called a craniotomy. In less serious cases ofsubdural hematoma, diuretics and corticosteroids may be used to reduce swelling.

While many cases of hematoma are recognized early and receive prompt care, they may still cause seizures that persist for years after the injury. Fortunately, most remit with therapy and time. Cognizance of the symptoms and conscientious care are the best approaches to improving subdural hematoma health outcomes.

See also Brain Trauma

Brain Injury Symptoms

Causes of Memory Loss

Military TBI

For more information about this topic consider these resources:

Abusive Head Trauma Quick Reference: For Health Care, Social Service, and Law Enforcement Professionals [Spiral-Bound] by Lori Frasier, Kay Rauth-Farley, Randell Alexander,and Robert Parrish

Surviving Head Trauma : A Guide to Recovery Written by a Traumatic Brain Injury Patient [Kindle Edition] Terry Smith

Return from Subdural Hematoma to Brain Injury

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