The classic presentation of an epidural hematoma is a loss of consciousness after the injury, followed by a lucid interval then neurologic deterioration. This classic presentation only occurs in less than 20% of patients. [ncbi.nlm.nih.gov]

Presentation varies widely in acute subdural hematoma (see Clinical). Many of these patients are comatose on admission. [emedicine.medscape.com]

Cephalalgia 26: 1245–6 Article CAS PubMed Google Scholar Williams EC, Buchbinder BR, Ahmed S, et al (2014) Spontaneous intracranial hypotension: presentation, diagnosis, and treatment. [link.springer.com]

These tests create images of the interior of the skull, usually detecting any subdural hematoma present. MRI is slightly superior to CT in detecting subdural hematoma, but CT is faster and more readily available. [webmd.com]

• Unconsciousness

  These symptoms include: Headache Vomiting Difficulty walking Difficulty balancing Vision changes Muscle weakness Numbness or paralysis Confusion Drowsiness Slurred speech Unconsciousness If left untreated, a subdural hemorrhage can lead to paralysis, [rwjbh.org]

  If pressure inside the skull rises to a very high level, a subdural hematoma can lead to unconsciousness and death. [webmd.com]

• Asymptomatic

  A subdural hygroma may therefore also occur after head trauma; they are frequently asymptomatic. [emedicine.medscape.com]

• Hypertension

  With increasing intracranial pressure there may be a Cushing response (hypertension, bradycardia, and bradypnea). [ncbi.nlm.nih.gov]

  In older patients, cardiovascular disease and arterial hypertension are found to be more prevalent. In one study, 16% of patients with chronic subdural hematomas were on aspirin therapy. [emedicine.medscape.com]

• Diplopia

  Other symptoms include dizziness, nausea, vomiting, diplopia, seizures, loss of consciousness, or nuchal rigidity. [ncbi.nlm.nih.gov]

• Mood Swings

  Symptoms of a subdural haematoma can include: a headache that keeps getting worse feeling and being sick confusion personality changes, such as being unusually aggressive or having rapid mood swings feeling drowsy loss of consciousness The symptoms can [nhs.uk]

• Slurred Speech

  These symptoms include: Headache Vomiting Difficulty walking Difficulty balancing Vision changes Muscle weakness Numbness or paralysis Confusion Drowsiness Slurred speech Unconsciousness If left untreated, a subdural hemorrhage can lead to paralysis, [rwjbh.org]

  Intraparenchymal Hemorrhage Non-traumatic intraparenchymal hemorrhages typically present with a history of sudden onset of stroke symptoms including a headache, nausea, vomiting, focal neurologic deficits, lethargy, weakness, slurred speech, syncope, [ncbi.nlm.nih.gov]

Common workup includes either a CT angiogram (CTA) of the head and neck, magnetic resonance angiography (MRA) of the head and neck, or diagnostic cerebral angiogram of the head and neck done emergently to look for an aneurysm, AVM, or another source of [ncbi.nlm.nih.gov]

Treatment options Treatment for subdural hemorrhages depends on the severity of the condition. For minor hemorrhaging, observation may be the only treatment necessary. Surgery may be required for more severe situations. [aurorahealthcare.org]

Subdural Hematoma Treatment Treatment of subdural hematomas depends on their severity. Treatment can range from watchful waiting to brain surgery. [webmd.com]

Treatment varies depending on the etiology of the hemorrhage but can include treatment of an aneurysm or arteriovenous malformation or other etiology. [ncbi.nlm.nih.gov]

A subdural hemorrhage is an emergency that requires immediate treatment. Our team of board-certified neurosurgeons can treat subdural hemorrhage and other types of brain injury. [rwjbh.org]

When to seek medical advice You should always seek emergency medical treatment after a severe head injury. Go to your nearest A&E department or call 999. [nhs.uk]

Each type of hemorrhage results from different etiologies and the clinical findings, prognosis, and outcomes are variable. [ncbi.nlm.nih.gov]

Findings on CT scan or MRI may help indicate prognosis. [emedicine.medscape.com]

Your prognosis is best if your subdural hematomas are chronic, you deal with few symptoms, and you didn’t lose consciousness after your head injury. Older adults are at the highest risk of another brain bleed after a subdural hematoma. [webmd.com]

Treatment varies depending on the etiology of the hemorrhage but can include treatment of an aneurysm or arteriovenous malformation or other etiology. [ncbi.nlm.nih.gov]

Subdural hematoma may also be spontaneous or caused by a procedure, such as a lumbar puncture (see Etiology). Rates of mortality and morbidity can be high, even with the best medical and neurosurgical care (see Prognosis). [emedicine.medscape.com]

Epidemiology and Clinical Manifestations of Immune Thrombocytopenia. Hamostaseologie. 2019 Aug;39(3):238-249. [PubMed: 30868551] 2. [ncbi.nlm.nih.gov]

Epidemiology of chronic subdural haematoma. Acta Neurochir (Wien). 1975. 32(3-4):247-50. [QxMD MEDLINE Link]. Mashour GA, Schwamm LH, Leffert L. [emedicine.medscape.com]

Increased ICP may also decrease cerebral flood flow, possibly causing ischemia and edema; this further increases the ICP, causing a vicious circle of pathophysiologic events. [emedicine.medscape.com]

Pathophysiology Epidural Hematoma Epidural hematomas occur when blood dissects into the potential space between the dura and inner table of the skull. Most commonly this occurs after a skull fracture (85% to 95% of cases). [ncbi.nlm.nih.gov]

Prevention The best way to prevent subdural hemorrhage is by avoiding head injury. [rwjbh.org]

Subependymal hemorrhage following drainage of chronic subdural hematoma: Probable causative mechanisms and prevention strategies. J Neurosci Rural Pract. 2015; 6(2):252. Doi: 10.4103/0976-3147.150303 Kalfas IH, Little JR. [medigraphic.com]

Smaller and non-operable hemorrhages may be managed medically with control of blood pressure, the reversal of anticoagulation or antiplatelet agents, and neuroprotective strategies to prevent and/or mitigate secondary cerebral injury. [ncbi.nlm.nih.gov]