Subdural Haematoma: The Forgotten Head Injury

Suffering a head injury in a fall or say a road accident, is a common cause of subdural haematoma which is shortened to SDH.  However in up to a half of patients they do not remember any incident that may explain it.  Particularly in older people the head injury may have been minor such as simply walking into a door or an indirect trauma that simply jostled the brain.  

Rising Subdural Hameatoma

The amount of SDH has been rising steadily over the last 40 years as our population has aged and a third of cases affect people aged over 80.  SDH is far more common in men and apart from a history of brain injury, risk factors include heavy drinking because liver damage can disrupt blood clotting.  Those on anticoagulant medication such as warfarin are also at higher risk as are those who are obese.

The Shrinking Brain

As people grow older the brain shrinks and leaves a space where fluid can collect.  The brain’s veins which cross this space are then more susceptible to tearing and even the smallest knock may make them leak, trapping blood against the brain.

What are the signs of SDH?

Patients may develop a severe headache and weakness on one side of the body, have difficulty walking, seem confused or have trouble speaking.  The symptoms often develop rather suddenly and without an obvious explanation.  The many possible symptoms can confusingly resemble psychiatric disorder, dementia, migraine, epilepsy, Parkinson’s disease, a stroke or mini-stroke.  Doctors however need to be aware of a possible subdural haematoma. 

How to diagnose subdural haematoma?

Doctors can order a CT scan to reveal or rule out a subdural haematoma, though it may need to be repeated with a dye if the results are unclear first time round.  Warning signs which doctors and people should look out for include headache, a change in mental status or a worsening of pre-existing neurological or psychological illness, as well as neurological problems in a specific location, such as one side of the face, an arm or even a small area of the tongue.

What is the treatment?

If there is bleeding into the subdural space, it puts pressure on the brain which can cause loss of consciousness, permanent disability or even death.  In these cases surgery will be needed to relieve the pressure.  However treatment of chronic SDH is not needed in two-thirds of cases, as the haematoma is reabsorbed naturally by the body without surgery.  Patients can be given medication to help speed up this process.  It is important though that people who have what looks like a stable haematoma should be monitored and treated promptly if symptoms worsen.  

How to avoid subdural haematoma?

The risk of developing SDH can be lowered by avoiding alcohol, reducing the risk of falling and maintaining a normal body weight.  Although there is no certain way to minimise brain shrinkage with age, research suggests that exercise does promote survival of the brain’s cells.

Head Injury UK: Brain Injury Claim Experts

Our specialist brain injury solicitors hope that increasing awareness of this condition which help save lives because if surgery is needed, it should be done urgently.  If you or a family member has been affected by subdural haematoma or other brain injury which was someone else's fault, please contact Ian Shovlin to discuss a possible claim or call on 0800 073 0988 to see how we can help.

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