When we hit our head somewhere, we may think, "Oh, it's just a small bump," but sometimes it can be more serious than that. Especially when things like headache , vomiting, and difficulty speaking come on a few days after a head injury, it's not good to think simply. This can be a serious condition related to the brain. Today we're talking about Subdural Hematoma, a dangerous condition that we all need to be aware of.
Simply put, what is this Subdural Hematoma?
Simply put, this is when blood collects between the protective membranes that surround our brain. Think about it, our brain is a very delicate organ. There are several layers of membranes inside the skull to protect it. What happens in this is that a delicate blood vessel under the 'dura' membrane, which is located under the skull but outside the brain tissue, ruptures and blood collects.
This bleeding does not occur inside the brain, but outside the brain. But the problem lies elsewhere . The skull is like a closed, hard box. So this blood starts to accumulate, and the brain starts to press. This increase in pressure is very dangerous. This pressure can damage the brain, make a person unconscious, or even be life-threatening.
Is this different from an epidural hematoma?
Yes, both are bleeding in the head, but there is a slight difference. In an epidural hematoma, the blood collects above the dura membrane we talked about earlier, which means it is closer to the skull. It usually requires a very strong blow. And its symptoms often appear quickly. However, a subdural hematoma is much more common.
There are three main types of this bleeding:
Subdural hematomas can be divided into three main types based on how quickly they develop. This is important to understand, as the symptoms and severity depend on the type.
| Hematoma type | Time and nature | Commonly seen symptoms |
|---|---|---|
| Acute Subdural Hematoma (Emergency) | Bleeding occurs rapidly within minutes or hours after a severe head injury. This is the most dangerous type. | Confusion, loss of consciousness, nausea, vomiting. Immediate medical attention is essential. |
| Subacute Subdural Hematoma (subacute condition) | Bleeding occurs quite slowly. Symptoms appear several days or weeks after a head injury. | Severe headache, vomiting, and gradual increase in confusion. This is also a dangerous condition. |
| Chronic Subdural Hematoma (long-term condition) | It is very common among older people. As the brain ages, it shrinks slightly, causing tiny blood vessels to stretch and bleed slowly, even with the slightest injury. Symptoms may develop over weeks . | Confusion, memory loss, difficulty walking, loss of balance. Often mistaken for signs of aging or dementia. |
What symptoms should you watch out for?
The symptoms of a subdural hematoma vary depending on the rate of bleeding. Sometimes, you may lose consciousness immediately after a head injury. But sometimes, you may not experience any symptoms for several days, and then symptoms may appear later.
In general, keep an eye out for these characteristics:
- A persistent severe headache
- Confusion , changes in gait
- Nausea and vomiting
- Excessive sleepiness, constant tiredness
- Weakness on one side of the body (especially the side opposite the head injury)
- Difference in the size of the pupils of the two eyes
- Difficulty speaking or slurred speech
- Memory loss
- Seizures
- Vision changes
If you experience any of these symptoms, whether a day or a week after a head injury, do not waste time and immediately see a doctor or go to the hospital's Emergency Department (ETU) . This can be a life-or-death situation.
The main causes and risk factors for this condition
The main cause is a head injury . These can be:
- Falls (especially in the elderly)
- Vehicle accidents
- Attacks
- Sports accidents (e.g. boxing, rugby)
In addition, this risk is higher for some people.
- Older people: As the brain naturally shrinks slightly as we age, the delicate blood vessels between the brain and the skull become stretched. This can cause them to rupture and bleed even with a minor blow.
- People taking blood thinners: People taking medications such as Warfarin and Aspirin are at risk of severe bleeding even from a minor accident.
- People who drink alcohol excessively: Alcohol causes brain shrinkage and increases the risk of falling.
- Young infants: This condition can occur in cases such as "Shaken baby syndrome" or due to accidents during birth.
How do you find this, Doctor?
Usually, when you go to the hospital after a head injury, the first thing your doctor will do is order a CT scan or MRI scan of your head. These scans can clearly show any bleeding inside your skull. CT scans are faster and are more commonly used in emergencies. MRI scans can provide even more detailed information.
How is it treated?
Treatment depends on the amount and type of bleeding, and the patient's condition.
- Observation: If the bleeding is very small and the symptoms are not severe, your doctor may decide to keep you in the hospital for observation without surgery. But they will continue to scan you to see if the bleeding gets worse or if it resolves on its own.
- Surgery: If the bleeding is large and causing pressure on the brain, surgery may be necessary to remove the blood.
- Burr hole trephination: This involves drilling a small hole in the skull above the area where blood has collected, inserting a tube through it, and suctioning out the blood.
- Craniotomy: If the bleeding is large or a blood clot has formed, a small part of the skull is temporarily removed, the blood is completely drained, and the skull is reattached.
The most important thing is that only the doctor can decide whether this can be cured without surgery. Never stay home in a situation like this.
How to escape from this situation?
The best way to prevent a subdural hematoma is to avoid head injuries .
- Always wear a helmet when riding bicycles and motorcycles.
- When riding in a vehicle, wear a seat belt .
- Be aware of areas in your home where people may slip and fall (e.g., bathroom, stairs), especially if there are elderly people. Make them safe.
- Control your alcohol intake.
- If you are taking blood thinners, talk to your doctor about the risks of even a minor accident.
Take-Home Message
- Subdural hematoma is a very serious condition that can occur after a head injury.
- It can take days or weeks for symptoms to appear after a head injury, so always be vigilant.
- If you experience symptoms such as severe headache, vomiting, confusion, or difficulty walking, see a doctor immediately.
- Especially the elderly and those taking blood thinners need to be careful of this, even after a minor fall.
- Protecting your head is the best way to prevent this situation. Always be safe.
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