Subdural hematoma (bleeding on brain)

Description The brain is surrou...

Description

The brain is surrounded by three linings, and the outermost is the dura mater. Head trauma can result in bleeding in the space between the dura and the brain. The bleeding normally occurs from injured veins in the dura. As the bleeding continues it causes pressure on the brain resulting in the symptoms and damage to the brain. Bleeding can be recognized immediately, an acute subdural, or many weeks after the initial injury, a chronic subdural. Symptoms can vary from complete paralysis and coma to mild alterations in behavior. This disorder is most commonly found between the ages of 50-70 and any disorder that prevents normal blood clotting increases the risk of this disorder.

Symptoms

Recent head injury, headache, loss of consciousness after head injury, weakness, numbness, can't speak, slurred speech, nausea and vomiting, lethargy, seizures, confusion, change in behavior.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. Tests done to identify the bleeding and any factors contributing to the bleeding will be done. A head CT is the most common imaging test.

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Magnetic resonance imaging (MRI)

Other Specific Tests: PT (Protime), PTT (Partial Thromboplastin Time)

Specialists:
Neurosurgery

Treatment

A subdural hematoma might require emergency treatment. Therapy depends on the size of the bleeding, the location of the injury, the length of time it has been present and the patient's other medical problems. Small subdural hematomas are allowed to heal on their own. Treatment may include: surgery, diuretics to reduce swelling, reversal of any bleeding abnormalities, and/or antiseizure medications.