A chronic subdural hematoma is a collection of blood under the outer lining of the brain, often caused by stretched or leaking bridging veins. Symptoms can include confusion, memory loss, and headaches. Surgery is required to treat it, and the risk of permanent brain damage is greater if left untreated. It is more common in people over 60 and those taking anticoagulant medications or with long-term alcohol and substance abuse.
A subdural hematoma is an accumulation of blood under the dura mater, which is the outer lining of the brain. This condition occurs when the bridging veins, which run between the surface of the brain and the dura mater, begin to leak or bleed, often after they have been stretched or excessive force has been applied to them. A chronic subdural hematoma indicates that blood started collecting more than 21 days ago. The other most common type of subdural hematoma is an acute subdural hematoma in which the bleeding started less than 72 hours ago.
A patient with a chronic subdural hematoma may present with a variety of symptoms that can vary from patient to patient, influenced by factors such as age, lifestyle, indications of recent trauma, and medical history. Many symptoms of chromic subdural hematomas are very similar to those of other conditions. Symptoms can include anxiety, depression, memory loss and confusion, often mimicking the signs of dementia. Convulsions and persistent headaches are also common.
Many symptoms can cause further complications. For example, someone with this condition may have trouble swallowing, which can lead to choking and aspiration. Weakness in the limbs can lead to poor mobility and increase the risk of falls and further injury. Confusion and an altered mental state can lead to poor judgment, increasing the risk of injury and poor decisions.
A chronic subdural hematoma requires surgery and won’t heal on its own, as the blood collection has nowhere to go. The procedure to treat this condition is known as a craniotomy. The procedure involves creating a small opening in the skull and draining the accumulated blood. Both surgery and the untreated condition carry the risk of permanent brain damage, but the risk is much greater in cases where the chronic subdural hematoma is left untreated.
Often caused by a head injury, chronic subdural hematoma is more likely to occur in people over the age of 60. As part of the natural aging process, the brain can shrink or atrophy, which means that the surface area of the brain becomes smaller, leaving more space between the dura mater and the brain surface. The bridging veins are then stretched, with greater force being placed on them, posing a greater threat of leakage and hematoma formation with even lesser head trauma.
People taking anticoagulant medications are at increased risk for chronic subdural hematoma because blood isn’t able to clot as effectively if the bridging veins begin to leak. In infants, subdural hematoma is often caused by trauma or abuse such as shaken baby syndrome. Other people at higher risk of developing a chronic subdural hematoma include those with long-term alcohol and substance abuse.
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