Chronic subdural haematoma is a condition in which blood collects between the surface of the brain and the skull. It is typically caused by a traumatic head injury.
Chronic subdural haematoma symptoms
Among the typical symptoms of chronic subdural haematoma are feeling sick, vomiting, a recurring and intensifying headache, mood swings and personality changes, confusion, loss of consciousness and drowsiness.
Chronic subdural haematoma symptoms typically occur a few days or weeks following a minor head injury, rather than soon after a serious head injury, as is the case with acute subdural haematoma.
Investigations
Initial checks into suspected chronic subdural haematoma often begin with the assessment of a patient’s medical history and asking if an individual has recently injured their head, as well as checking for symptoms such as a worsening headache.
A doctor will typically check if a patient is taking medication such as warfarin and aspirin, which can be used to prevent blood clots, as it can increase chances of subdural haematoma.
Signs of head injury are typically assessed, and the Glasgow Coma Scale (GCS) can be used to check the patient’s level of consciousness. Brain scans are a very common method of investigation for those with suspected chronic subdural haematoma, usually in the form of a computerised tomography (CT) scan.
Treatments
While monitoring of very small subdural haematomas may be undertaken to see if they heal without the need for a surgical procedure, in most cases, surgery is the recommended form of treatment.
Surgery
Surgery for chronic subdural haematoma is typically carried out by a neurosurgeon. The main type of surgery for chronic subdural haematoma is burr holes. A second surgical procedure, craniotomy, involves the temporary removal of a section of the skull and is usually only carried out to address acute subdural haematoma.
Burr holes involve the drilling of a small hole or holes into the skull, through which a tube is inserted to drain the haematoma. The tube can be left in place for a period following the operation, to drain away any residual blood and help prevent the haematoma from returning. Typically, burr hole surgery is carried out using general anaesthetic, but sometimes uses local anaesthetic.
Recovery
After successful surgery with no complications, patients are usually able to leave hospital after a stay of a few days. Full recovery time varies from patient to patient. While some people feel much better after a short recovery period, others may not see a complete recovery.
