Chronic subdural hematoma - Getting into the head of a superhero

  • By Team TDO

The brain is a heavily protected organ in our body. Of course, it needs to be protected as if it were not for the brain; we would all be as good as dead!

The next time you take your bike out, be sure you wear your helmet. The moment you enter your car, wear your seat-belt. Think twice about popping an aspirin for all your headaches. As you may be placing yourself at a risk to develop subdural hematoma!

The brain has 3 main layers of protection. The innermost covering of the brain is called the Dura mater.
There are thousands of tiny blood vessels that flow through the brain. They are placed between the brain surface and the Dura mater. When these blood vessels rupture due to any cause, the blood leaks out and gets collected in the ridges of the brain. This is what is called as subdural hematoma.

The bleeding in subdural is outside the brain, not inside it as in a stroke. The resultant blood clot puts pressure on the brain matter leading to several neurological symptoms.

Causes of subdural hematoma:

  1. Long term indulgence in alcohol.
  2. Long term use of aspirin and other blood thinning agents.
  3. Long term use of anti-inflammatory drugs like Ibuprofen.
  4. Head injury.
  5. Old age.

Symptoms of subdural hematoma:

  1. Severe headache
  2. Tingling and numbness in hands and arms
  3. Constant drowsiness
  4. Seizures
  5. Difficulty in speaking
  6. Decreased memory

What to expect when you go to see your neurosurgeon?

Your doctor will get a detailed history stressing on the medications and head injury part. He will assess you for:

  1. Balance
  2. Co-ordination
  3. Muscle strength
  4. Mental functions
  5. Walking

An MRI or CT scan will also be advised to rule out other possibilities and also to evaluate the location and size of the hematoma.


If the hematoma is not causing any symptoms, it may be left as it is.

If the hematoma is causing symptoms then it does need treatment. Based on your MRI reports, your doctor may decide if the hematoma is big or small.

A small hematoma will just require drilling a small hole in the head that will cause the accumulated fluid and blood clot to flow out. If it is a big one, there will have to be a bigger surgery called Craniotomy that involves opening up your skull.

Prognosis: Small hematomas that do not cause symptoms heal on their own. The big ones that require surgery have a chance of developing again with the need for more surgeries.

Complications: Since anything related to the brain carries a high level of risk with it, drilling in hole can be extremely risky! The potential complications include:

  1. Permanent brain damage.
  2. Persistent symptoms of anxiety, confusion, lack of ability to pay attention, memory loss, dizziness and headache.
  3. Frequent seizures.