Home > Blog > Neurosurgery > Subdural hematoma

Subdural hematoma

A subdural hematoma, the removal of which should be carried out immediately after the first symptoms are detected, is characterized by the accumulation of blood between the meninges (arachnoid and dura). This hematoma compresses the soft tissues of the brain, causing several complications, in particular, disruption of the central nervous system.

Causes of development

A subdural hematoma of the brain develops as a result of an injury to the cranium. Subdural hematoma, the treatment of which should be timely, is not just a big lump on the head, but a dangerous pathology that can lead to serious consequences. The peculiarity of this type of hematoma is that an extensive hemorrhage is observed both from the side of the brain where the blow occurred and in the mirror image, that is, from the opposite.

The development of a subdural type hematoma starts, as a rule, in a few days after injury. Traumatic hematoma of the brain appears not only due to mechanical damage to the cranium but also due to minor hemorrhages caused by the breakage of blood vessels (as a result of atherosclerosis, hypertension).

Clinical manifestations

Symptoms of a subdural hematoma are different, depending on its size, the degree of trauma, the presence of concomitant diseases in the patient. The main signs characterizing the pathology are as follows:

  • frequent fluctuations in blood pressure;
  • change of consciousness;
  • headache;
  • psychomotor agitation;
  • epileptic seizures;
  • vomiting
  • development of the retrograde type of amnesia;
  • noise in ears;
  • disturbances in the central nervous system;
  • mental changes.

Methods of treatment and diagnosis

A subdural brain hematoma is diagnosed by a neurological examination of the patient. To confirm the initial diagnosis, determine the size of the hematoma and the presence of complications, MRI and CT are performed.

Subdural hematoma on CT.

Treatment of a subdural hematoma of the brain requires immediate hospitalization of the patient, one of the methods that are preferred is the removal of the blood clot.

The use of conservative methods of therapy is not excluded. Positive dynamics from taking medications will be only if the hematoma has not yet managed to reach large sizes, and if the symptomatic picture is poorly expressed. The conservative method consists of a set of measures that are aimed at restoring blood circulation in the soft tissues of the brain and normalizing the metabolic process. The patient is prescribed analgesics, vitamin complexes, and blood thinners.

Since conservative therapy does not always give positive results, surgery is the preferred method for treating subdural hematoma. The patient undergoes trepanation – the opening of the cranium, followed by the removal of the hematoma. Excess blood is removed through a syringe, or the method of washing the cavity with saline is used. After extracting the blood clot, the integrity of cranium is returned, with the installation of special drainage, to prevent re-accumulation of blood.

If the pathology was detected in the early stages and did not increase in size, the endoscopic method is used – a small hole is made in the skull and blood clots are removed through it with the help of special tools. In the treatment of subdural hematoma, the price depends on the method chosen.