Treatment:

A subdural hematoma is an emergency condition!

Emergency surgery may be needed to reduce pressure within the brain. This may involve drilling a small hole in the skull, which allows blood to drain and relieves pressure on the brain. Large hematomas or solid blood clots may need to be removed through a procedure called a craniotomy, which creates a larger opening in the skull.

Medicines used to treat a subdural hematoma depend on the type of subdural hematoma, the severity of symptoms, and how much brain damage has occurred. Diuretics and corticosteroids may be used to reduce swelling. Anti-convulsion medications such as phenytoin may be used to control or prevent seizures.

Expectations (prognosis):

The outlook following a subdural hematoma varies widely depending on the type and location of head injury, the size of the blood collection, and how quickly treatment is obtained.

Acute subdural hematomas present the greatest challenge, with high rates of death and injury. Subacute and chronic subdural hematomas have better outcomes in most cases, with symptoms often going away after the blood collection is drained. A period of rehabilitation is sometimes needed to assist the person back to his or her usual level of functioning.

There is a high frequency of seizures following a subdural hematoma, even after drainage, but these are usually well controlled with medication. Seizures may occur at the time the hematoma forms, or up to months or years afterward.

Complications:

• Brain herniation (pressure on the brain severe enough to cause coma and death)
• Persistent symptoms such as memory loss, dizziness, headache, anxiety, and difficulty concentrating
• Seizures
• Temporary or permanent weakness, numbness, difficulty speaking

Calling your health care provider:

A subdural hematoma requires emergency medical attention. Call 911 or your local emergency number, or go immediately to an emergency room after a head injury.

Spinal injuries often occur with head injuries, so try to keep the person's neck still if you must move him or her before help arrives.