Chronic Subdural Hemorrhage (Hematoma)
The brain has three layers of tissue, with its outermost layer, which is adjacent to the skull, referred to as the dura. Chronic subdural hemorrhage is a condition in which blood slowly leaks beneath the outermost layer of the dura, occurring in about 25% of people who suffer head injuries, often developing 3-4 weeks after an accident involving severe shaking or impact to the head.
How dangerous is chronic subdural hemorrhage?
This is a condition with the potential to cause disability or even death if not diagnosed and treated in a timely manner. It occurs when blood slowly accumulates under the dura, the outermost layer of the brain that is next to the skull. The gradual nature of the condition means patients may initially present with no symptoms or only experience very mild symptoms for several weeks or months, with more obvious symptoms only starting to appear when significant bleeding has occurred, and the brain's function is impaired.
What are the symptoms of chronic subdural hemorrhage?
- Persistent headaches.
- Dizziness, loss of balance, and difficulty walking.
- Nausea and vomiting.
- Fatigue.
- Confusion and difficulty speaking.
- Lethargy.
- Nervous system abnormalities and weakness in the arms and legs.
- Memory loss and personality changes, especially prevalent in the elderly.
In case of severe bleeding in the brain, the patient’s situation may deteriorate and involve the following symptoms:
- Paralysis.
- Seizures.
- Breathing difficulties.
- Loss of consciousness.
Which groups are most at risk?
- Those who have sustained a head injury.
- The elderly.
- Young infants.
- Patient taking anticoagulant drugs.
- Athletes who play high-impact sports.
- Those who consume excessive amount of alcohol.
How is chronic subdural hemorrhage diagnosed?
This condition can be diagnosed using a
CT or
MRI scan of the brain.
What treatments are available for chronic subdural hemorrhage?
- For patients with less severe bleeding, treatment usually involves attempting to alleviate the symptoms alongside monitoring their brain condition using CT and MRI scans during recovery.
- For patients with severe bleeding, an operation may be required to treat the condition.
What risks are associated with treatment for chronic subdural hemorrhage?
Chronic subdural hemorrhage is a condition with a high rate of repeat occurrence, however, the potential risks associated with surgery to treat this condition are no different to other forms of surgery, such as increased bleeding, a seizure during surgery, and infection at the incision site.
How can chronic subdural hemorrhage be prevented?
- The elderly and patients taking anticoagulant drugs should be careful regarding falls or impacts to the head.
- Attempt to prevent head injuries and seek medical attention immediately if such an injury does occur.
- Avoid excessive alcohol consumption.
- Be careful not to shake or jolt young infants.
- Monitor the brain function of those belonging to high-risk groups.
The Neuroscience Center at Bumrungrad International Hospital has a team of highly experienced specialists ready to provide treatment for cases of chronic subdural hemorrhage. Such treatments include middle meningeal artery embolization, a technique involving catheterization of the blood vessel in the brain to block the blood flow to the affected area and allow hematoma resolution. It is both safe and highly effective in reducing the potential complications associated with surgery, while also helping to reduce the likelihood of a repeat occurrence of the condition in the future.
Dr. Chayot Chanmanon
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