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Chronic subdural hematoma: Slow, subtle and dangerous

On Behalf of | May 22, 2017 | Brain Injuries

A head injury generally requires a trip to the nearest Massachusetts doctor. However, the chronic subdural hematoma can be tricky to identify because it may not result from standard head trauma and can take a significant amount of time to cause worrying symptoms.

According to Healthline, a subdural hematoma results when a vein bursts between the surface of the brain and the skull, allowing blood to pool and put pressure on the brain. Subdural hematomas come in two forms—acute and chronic. The former occurs quickly, often as the result of a serious injury to the brain, and symptoms appear rapidly. The latter variety, however, may form as the result of a gentler bump to the head or even have no apparent cause. Symptoms of these hematomas can take weeks to manifest.

Warning signs of a subdural hematoma may range from headaches to comas and can includes issues with sight or speech, weakness, numbness, seizures or loss of consciousness. Persons who experience these symptoms should visit a doctor right away because a subdural hematoma left undiagnosed and untreated can be life threatening.

Once the patient arrives at the hospital, doctors may recommend an MRI, CT or other imaging test to gain a picture of the skull, the brain and its blood vessels. Doctors may be able to drain milder subdural hematomas via a burr hole in the skull, but more severe hematomas require surgical intervention.

Chronic subdural hematomas can be particularly problematic, as National Public Radio reports, for two reasons: doctors may not recognize them right away, and patients may not remember sustaining a head injury. For instance, one doctor was unaware that he himself had obtained a subdural hematoma until he sought treatment for back pain. His neurosurgeon recommended an MRI and discovered a sizeable buildup of blood on the doctor’s brain.

The elderly are particularly at risk for subdural hematomas because the brain shrinks over time, leaving blood vessels exposed. In some cases, the sort of mild jostling that might occur when one falls but catches oneself is sufficient to damage the veins traveling into the brain. These vessels then leak blood at a slow rate, so it takes some time for the problem to become apparent.

Researchers believe that hospitals in the United States may diagnose 200,000 or more subdural hematomas every year. However, this number does not account for the unknown numbers of patients who receive a misdiagnosis or are never diagnosed at all, an issue that is heightened by the fact that many patients have no reason to report a head injury because even if they did hit their heads, they may not remember the incident.