Subdural Hematoma

By | June 10, 2022

A subdural hematoma is bleeding in the brain and usually occurs as a result of head injuries. A distinction is made between acute and chronic subdural hematoma, whereby the symptoms are the same in both cases, but can occur at different speeds. Prompt diagnosis is particularly important as life-threatening complications can occur.

What is a subdural hematoma?

Subdural hematomas usually result from a head injury and can sometimes be life-threatening. It is a cerebral hemorrhage, which is located in the calvaria on the surface of the brain. A distinction is made between an acute and a chronic form. For hypoxia in English, please visit

An acute subdural hematoma results from a serious head injury, and a chronic one can result from minor head injuries or frequent falls. The term is also used for blood clots on the surface of the brain. These can arise as a result of congenital vascular malformations or due to risk factors such as high blood pressure, smoking or obesity.


As soon as there is a rupture between the skull and the surface of the brain, i.e. the vein bursts, so-called subdural hematomas develop. A severe head injury can cause the space between the brain and skull to fill with blood. This acute subdural hematoma is among the most dangerous of its kind, as it can cause life-threatening symptoms.

Acute subdural hematomas most often result from a hit or bump to the head, from falling, or more commonly, from automobile accidents. These hematomas appear immediately along with the symptoms. Chronic subdural hematomas, on the other hand, develop slowly. The cause is considered to be minor or repetitive head injuries.

It is therefore often the case that older people are affected if there have already been several falls. The symptoms usually appear later, sometimes even a few weeks in between and are therefore not recognized immediately. Treatment is simpler, but life-threatening complications can still occur.

Symptoms, Ailments & Signs

The symptoms of a subdural hematoma appear immediately in the acute form and belatedly or not at all in the chronic form. However, recognizing the symptoms is extremely important in order to be able to receive treatment in time. The most common symptoms are headaches, speech disorders and convulsions. Visual disturbances, numbness, weakness and loss of consciousness can also be noticeable as side effects.

Diagnosis & course of disease

In order to be able to diagnose a subdural hematoma, an examination using MRI (magnetic resonance imaging) or CT (computed tomography) is necessary. A complete blood count can also provide information about the number of red and white blood cells, as a too low number of red blood cells indicates a heavy loss of blood. Sometimes a physical exam, blood pressure and heart rate can be checked, as these factors can indicate internal bleeding.


A subdural hematoma can cause a number of complications and, in isolated cases, also have long-term consequences. In most cases, the intracranial pressure increases in those affected who have suffered a craniocerebral trauma. This can lead to coma or death. Furthermore, seizures can occur, which are associated with an increased risk of accidents.

In the case of major injuries, muscle weakness or numbness in certain areas of the body is also conceivable. Typical late effects of a subdural hematoma are limitations in mental performance and neurological disorders. As a result of trauma, some patients also develop mental illnesses such as anxiety disorders or depression.

Since the surgical treatment of a subdural hematoma is a complicated procedure, small and large complications can occur. Possible risks of a craniotomy include bleeding and bruising, as well as infection and wound healing disorders. Occasionally, blood clots form, which can cause convulsions and sometimes death.

Particular risks when the skull is opened are damage to healthy brain tissue, leakage of brain fluid and accumulation of air in the skull cavity. The anesthesia can also be associated with incidents. For example, sudden heart failure can occur.

When should you go to the doctor?

After a head injury, careful assessment should be made of persistent or increasing discomfort. In the case of minor injuries, it is not always necessary to see a doctor. If symptoms disappear almost completely within a few minutes, there is usually no need for further treatment. However, if you feel ill, dizzy or have unsteady gait, you must consult a doctor.

Headaches, bleeding or damage to the skull bones should be examined and treated. Irrespective of whether the head injury was caused by a fall, impact, accident or violent impact, there may be damage which, in severe cases, can lead to irreversible damage or to the premature death of the person concerned. Therefore, a doctor’s visit is necessary for speech disorders, general functional disorders or sudden cramps. A sudden decrease in vision is to be understood as an alarm signal from the organism.

Because some patients can experience the symptoms described without an immediate head injury, a doctor should also be consulted if any irregularities occur without a bump or perceived impact to the head.

Sudden weakness, numbness or sensory disturbances should also be examined as soon as possible. In the event of disturbances of consciousness or loss of consciousness, an emergency service must be alerted. In these cases, there is a risk of death, so that the person concerned requires immediate medical care.

Treatment & Therapy

Acute subdural hematoma can only be treated in a hospital because brain swelling can occur at any time. This swelling causes increased intracranial pressure, which must be treated with special drill holes in the skull. A craniotomy is performed to remove a large subdural hematoma.

This is a surgical procedure, which must be carried out especially in acute cases. In this procedure, part of the skull is removed, and then the blood clot, or hematoma, is suctioned out and flushed out. In the case of smaller hematomas, it is possible to drain them using drill holes.

Thin tubes are inserted into small holes in the skull, allowing blood to escape from the hematoma. In addition, brain injuries are also treated with medication, since inflammation can be combated with corticosteroids, for example. Treatment or prevention of side effects such as cramps can also be done with appropriate medication.

Nevertheless, complications from subdural hematomas are not uncommon. These can occur even some time after treatment has been given. Permanent numbness, muscle weakness, seizures or increasing intracranial pressure can occur. The latter is particularly dangerous as it can lead to a coma or even death.

Complications can vary in severity depending on the severity of the skull injury. A prognosis also depends on the severity of the injury, the location, and the extent of the subdural hematoma. In the case of chronic subdural hematomas, the chances are good, whereas the acute form can be very different. According to the United States Department of Neurosurgery, ULCA, about 50 to 90 percent of cases die from the disease or complications.


Due to congenital vascular malformations, bleeding in the brain can occur at any time, and prevention is not possible in this case. However, high blood pressure is also considered a huge risk of cerebral hemorrhage and can be treated accordingly. Regular medical check-ups are therefore essential if high blood pressure has already been diagnosed.

Smoking also doubles or triples the risk of cerebral hemorrhage. The same applies to regular, high alcohol consumption, severe obesity and high cholesterol levels. It is therefore possible to take preventive measures to reduce the risk of bleeding in the brain. Scheduled visits to the doctor, a healthy diet and sufficient exercise can already make a difference before problems arise.


Since the disease can quickly lead to thought disorders and many other complaints, those affected should avoid any stressful situations. The body should be sufficiently spared so that these complaints can be prevented. Since the disease is usually associated with a head injury, the injured person should be sufficiently cooled.

Ice packs and poultices are very useful to relieve discomfort and treat swelling. If the disease has already caused numerous symptoms, those affected must undergo physiotherapy. The cerebral hemorrhages caused by the disease can cause severe and permanent damage.

People suffering from the condition should visit a support group. It can be very helpful to talk to other sufferers about the disease. This also means that those affected do not feel alone and are introduced to methods and practices that show them how they can lead a largely normal life with the disease.

After the cerebral hemorrhage, the consequential damage can also be a change in the personality of those affected. It is very important that people with the condition see a psychologist. In addition, the relatives should be sufficiently informed about the disease so that immediate action can be taken in emergencies. The help and support of family members is imperative.

You can do that yourself

After a subdural hematoma, you may have trouble thinking and other neurological symptoms for some time. The most important self-help measure is to avoid stress and take it easy on the body.

Since a subdural hematoma usually occurs in connection with severe head injuries, the head must always be cooled. Cooling poultices, but also packs made of quark or medicinal ointments are available to relieve any swelling and pain. If the subdural hematoma has caused long-term problems, comprehensive physical therapy is required. In the case of severe cerebral hemorrhage, permanent disorders can remain. People who have suffered a subdural hematoma benefit from talking to other sufferers. The doctor can establish contact with a self-help group and, if necessary, call in other specialists and medical professionals. Personality changes may also occur after severe cerebral hemorrhage.

It is the duty of the relatives to support the affected person as much as possible. In addition, you should always pay attention to regular visits to the doctor. In the first few months after a cerebral hemorrhage, brain scans must be made regularly. If there are no abnormalities, no other measures must be taken apart from the typical therapeutic measures.

Subdural Hematoma