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. 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. In patients with a subacute hematoma, 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). An acute subdural hematoma should be treated with craniotomy (it is difficult to treat an acute subdural hematoma with burr holes because the clot cannot be evacuated well).

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.This is especially true in the setting of trauma because the mechanism of injury resulting in subdural hematoma is so severe that usually there is other underlying brain injury.

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

In adults, most recovery occurs in the first six months, with some improvement over approximately two 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
• Hydrocephalus
• Persistent symptoms such as memory loss, dizziness, headache, anxiety, and difficulty concentrating

Call Your Health Care Provider If:

Go to the emergency room or call the local emergency number (such as 9-1-1) if symptoms of subdural hematoma occur! Any person with a serious head injury should have his neck immobilized. If vomiting ensues, be prepared to turn victim on his side so he doesn't choke.

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
• Lethargy

Ency. home > Disease > S > Subdural hematoma - acute/subacute

---

[an error occurred while processing this directive]