A subdural hematoma (SDH) is a common neurosurgical disorder. A subdural hematoma is a collection of blood on the surface of the brain. SDH is a type of intracranial hemorrhage that occurs beneath the dura and may be associated with other brain injuries. SDHs are usually caused by trauma but can be spontaneous or caused by a procedure, such as a lumbar puncture. Subdural hematomas due to head injury are described as traumatic. Much more common than epidural hemorrhages, subdural hemorrhages generally result from shearing injuries due to various rotational or linear forces. A subdural hematoma is more common in the elderly because normal brain shrinkage occurs with aging that stretches and weakens the bridging veins.

A subdural hematoma also may be an indication of child abuse, as evidenced by shaken baby syndrome. Epidural hematoma (EDH) is a traumatic accumulation of blood between the inner table of the skull and the stripped-off dural membrane. Epidural hematoma commonly results from a blow to the side of the head and is frequently caused by a fracture that passes through an arterial channel in the bone, most commonly a break in temporal bone interrupting middle meningeal artery, a branch of the external carotid. Epidural hematomas may occur in combination with subdural hematomas, or either may occur alone. The signs and symptoms of an epidural hematoma include severe headache, dizziness, vomiting, increased size of one pupil or sudden weakness in an arm or leg.

Medicines used to treat a subdural hematoma depend on the type of subdural hematoma. Liquid blood can be drained from burr holes drilled into the skull. Emergency surgery may be needed to reduce pressure within 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. Corticosteroids and diuretics can control brain swelling. Rest in bed, stay warm, and limit your normal activities as much as possible for a few days. Always use safety equipment at work and play to reduce your risk of a head injury. Avoid head injuries by using seat belts, bicycle and motorcycle helmets, and hard hats when appropriate. You may also need to limit your diet to liquids.

Subdural and Epidural Hematoma Treatment and Prevention Tips

1. Corticosteroids and diuretics can control brain swelling.

2. Surgery is generally recommended to remove the clot.

3. Liquid blood can be drained from burr holes drilled into the skull.

4. Always use safety equipment at work

5. You may also need to limit your diet to liquids.

6. Avoid head injuries by using seat belts, bicycle and motorcycle helmets.

7. Bag-valve-mask ventilation with good technique may be of more benefit to brain injured patients.