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Subdural Hematoma

There are three membranes that protect the brain and spinal cord: the dura mater, arachnoid mater, and pia mater. A subdural hematoma occurs when blood accumulates beneath the dura mater, which is situated on the outer layer of the brain closest to the skull.

Subdural hematomas typically result from head injuries, but older adults and people with certain health conditions have a greater chance of experiencing them. Treatment typically depends on the severity of the condition, with the following medications being used to manage less serious effects:

  • Medications to Reduce Swelling in the Brain – Corticosteroids and diuretics can help manage inflammation in the brain. These drugs can prevent serious health effects in the event that a subdural hematoma causes dangerous swelling. 
  • Medications to Improve Blood clotting – People on blood thinners have a higher risk of experiencing a subdural hematoma, and these medications can also cause bleeding complications during treatment. Doctors can manage bleeding issues with antifibrinolytic drugs, which improve the body’s blood clotting ability. 
  • Medications to Prevent Seizures – Subdural hematoma can also carry a risk of seizures, particularly if brain surgery is necessary. In this case, doctors may prescribe antiseizure drugs like perampanel, clonazepam, topiramate, or another type of medication.

When Is Surgery Necessary to Treat a Subdural Hematoma?

The size and severity of a subdural hematoma can determine whether surgery is recommended. In this case, patients may undergo a burr hole procedure, which entails drilling holes into the skull through which tubes are threaded. These tubes drain blood over the course of several days to prevent dangerous pressure from building within the skull.

Surgeons can also perform a craniotomy, which is a full surgery that provides access to the subdural hematoma so it can be removed. Generally, burr hole procedures are used when a person experiences chronic issues, while craniotomies are recommended for acute hematomas, meaning those that happen suddenly and progress rapidly.

 

 
 
 

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