Subdural Hematoma

Most people will hit their heads at some point in their lives one way or another. A minor head injury can be a mild bruise, bump or cut on the head. On the other hand, a serious head injury can be an open wound or deep cut, broken skull, concussion, internal bleeding or brain damage.

Some people with serious head injuries may feel symptoms hours or even days after being injured, by which time their condition may have worsened. Even though a mild head injury may not require treatment, some people may develop serious symptoms later. Visit a doctor if you experience chronic headache, nausea or dizziness following a head injury. Nacogdoches Medical Partners in Nacogdoches, TX have physicians to provide you with proper medical diagnosis, evaluation and treatment for head injuries.

What Is a Subdural Hematoma?

The brain has three meninges or membrane layers that protect and cover the brain and spinal cord:

• Dura mater – the outer meninge closest to the skull.
• Arachnoid mater – the middle layer.
• Pia mater – the inner layer closest to the brain tissue.

The three spaces within these membrane layers are:

• Epidural space – located between the skull and dura mater.
• Subdural space – located between the dura mater and arachnoid mater.
• Subarachnoid space – a space between the arachnoid mater and pia mater that’s filled with cerebrospinal fluid, which protects and cushions the brain and spinal cord.

A subdural hematoma is a serious condition where blood collects between the brain surface and the brain covering (dura mater). A head injury can cause a blood vessel in these brain areas to stretch and tear, allowing blood to leak and accumulate.

Severe head injuries may cause the hematoma to progress rapidly. The blood collection in the brain compresses brain tissue and may lead to brain injury or even death if not treated immediately. On the other hand, a subdural hematoma arising from a minor head injury has less bleeding and develops more slowly.

Symptoms of Subdural Hematoma

The most common subdural hematoma symptoms include:

• Behavior changes
• Confusion or slurred speech
• Difficulty with balance or walking
• Dizziness
• Fatigue
• Headache
• Loss of consciousness
• Nausea and vomiting
• Seizures
• Vision problems
• Weakness or numbness

Seek immediate medical attention if you experience any of the symptoms above following head trauma.

What Is a Traumatic Brain Injury (TBI)?

A traumatic brain injury may result from a forceful blow to the head or an object that pierces the skull and reaches the brain. Some TBI types may affect a person temporarily, while others are more severe and may lead to permanent disability or death. Types of head injuries include:

• Concussion – the brain twists in or bounces around the skull due to a blow or jolt to the head, resulting in brain chemical changes and brain cell damage.
• Intracranial hematoma (ICH) – a condition wherein blood clots form in or around the brain.
• Subdural hematoma – blood clot forms outside the brain but underneath the skull and the dura.
• Epidural hematoma – blood clot forms on top of the dura and beneath the skull.
• Contusion (intracerebral hematoma) – a bruise to the brain that causes swelling and bleeding inside the brain area where the head received a blow. A contusion can also have non-traumatic causes, such as bleeding disorders or high blood pressure.
• Diffuse axonal injury (DAI) – a blunt injury to the brain that result in coma and damage to multiple parts of the brain.
• Skull fracture – a break in the skull.
  • Linear skull fractures – the skull fracture does not move the bone. Patients with this injury may only need hospital rest and may not need any interventions.
  • Depressed skull fractures – part of the skull is sunken from the trauma and may require surgery to help correct the deformity.
  • Diastatic skull fractures – fractures along the skull’s sutures or fibrous bones that connect skull bones.
  • Basilar skull fracture – the most serious skull fracture wherein there is a break at the skull base. Patients with this condition have bruises behind their ears and around their eyes. A clear fluid may also be draining from their ears or nose.

Difference Between Epidural and Subdural Hematoma

Epidural hematoma results from tearing the meningeal artery, which supplies blood to the dura mater. An artery carries oxygenated blood, so it is under pressure. As a result, blood collection in the epidural space happens quickly because the bleeding is under pressure. On the other hand, subdural hematoma results from the tearing of some brain veins under low pressure. The bleeding may happen slowly and may take more time to develop symptoms.

Traumatic Brain Injury Symptoms

The following head injury symptoms require immediate medical attention, especially within the first 24 hours after a TBI:

Physical symptoms:

• Balance loss
• Blurred or double vision
• Clear liquid draining from the ears or nose
• Dilated pupils
• Headache
• Nausea and vomiting
• Seizures or convulsions
• Slurred speech
• Unequal pupil size
• Weakness

Behavioral or cognitive symptoms:

• Altered state of consciousness
• Decreased consciousness level
• Difficulty concentrating, making decisions or remembering
• Disorientation
• Irritability
• Mild to profound confusion
• Loss of consciousness
• Sleep pattern changes

Sensations:

• Bad taste in the mouth
• Blurred vision
• Dizziness
• Feeling depressed or anxious
• Hearing problems
• Lethargy
• Lightheadedness
• Light or sound sensitivity
• Loss of coordination
• Mood changes
• Unusual behavior
• Vertigo

Never Ignore Symptoms of a Head Injury

Sometimes, head injuries can cause serious damage to the brain even though there is no visible external injury. Contact an emergency service after a head injury to get a proper assessment of your condition. Our neurosurgeons have extensive experience in diagnosing, evaluating and treating head injuries. Don’t delay care.