Chronic Subdural Hematoma (Hemorrhage)

Overview

This condition is a buildup of clotted blood between the brain's outer layer and the membrane that covers the brain (called the dura). It usually occurs in the elderly, and can be caused by even a minor bump to the head.

How it Forms

As we age, our brain tissue slowly shrinks. Blood vessels that extend from the brain to the skull stretch and become vulnerable to tears. The vessels can rupture on their own, or they can tear if the head is bumped or jolted. A single episode of leaking may go unnoticed, but repeated leaks can cause a dangerous buildup of blood. Medications that delay blood clotting may make the problem worse.

Symptoms

A chronic subdural hematoma usually progresses slowly. Symptoms may include severe headaches, drowsiness, and nausea. A hematoma may cause slurred speech, seizures, and cognitive decline. It may cause difficulty with swallowing or walking, and weakness or numbness in the face, arms or legs. These symptoms may happen days or even weeks after the injury.

Treatment

A chronic subdural hematoma that causes symptoms is treated with drainage of the accumulated blood. This usually can be done through a drain passed through a small hole in the skull. If seizures occur as a result of hematoma, they may be controlled with medications.