Presentations seen is dependent on the level of bleeding but general include siezures, apathy, weakness, lethargy, nausea, dizziness, behaviorual changes, confusion and severe headache. 

Chronic subdural hematoma may have presentation similar to what is seen with Parkinson disease. An acute presentation is equally possible as seen in patients who show seizure as a symptom.

Confusion and headache appears to be the most common presenting features as it is seen in as much as 90% to 56% of cases.

• Epilepsy

  CONCLUSIONS: In case of refractory treatment of epilepsy, dislocation of pacemaker electrodes is a, most certainly, rare but possible differential diagnosis. [ncbi.nlm.nih.gov]

  Also there is some history of trauma such as fall, epilepsy or motor vehicle accident. Investigations you would want to perform is the CT Scan. On CT Scan subdural hematoma will show in a more elliptical pattern. [youtube.com]

  As many as 10 percent of patients had a history of alcoholism or epilepsy, the Welsh team reported. Obesity can be a contributing factor by increasing estrogen levels in the body, Dr. Samadani said. [well.blogs.nytimes.com]

  Patients with a previous history of epilepsy are at particular risk to develop postoperative seizures. [pmj.bmj.com]

  Etiology Rupture of the bridging veins caused by: Blunt head trauma (most common) Shaken baby syndrome Frequent falls (e.g., due to old age, alcohol abuse, epilepsy, hyponatremia) Nontraumatic intracranial hemorrhage Idiopathic, or iatrogenic (i.e., surgical [amboss.com]

• Fatigue

  Classic symptoms of a chronic subdural hematoma include recurring headaches, personality changes, fatigue and dementia. Dementia in a subdural hematoma can be sometimes mistakenly confused with incipient Alzheimer's disease. [health-tutor.com]

  As you are recovering, you may experience fatigue, headaches, or neurological symptoms that are expected to gradually improve. Thanks for your feedback! Thank you, {{form.email}}, for signing up. There was an error. Please try again. [verywellhealth.com]

  Vomiting, numbness, and fatigue are also key manifestations. 7. [thrombocyte.com]

  Clinical presentation varies from general and mild symptoms (e.g. headache, fatigue) to severe symptoms (e.g. hemiparesis, coma). [intechopen.com]

  […] chronic pain requiring analgesic palliation can negatively impact sexual function, sleep hygiene, and mental alertness. 22 Reduced capacity to perform complex cognitive tasks may be attributable to the direct distraction of pain or related to associated fatigue [doi.org]

• Vomiting

  A 28-year-old healthy man was admitted to our hospital because of right-sided headache, vomiting, and lower back pain after the administration of vardenafil. [ncbi.nlm.nih.gov]

  Depending on the size of the hematoma and where it presses on the brain, any of the following symptoms may occur: Confused or slurred speech Problems with balance or walking Headache Lack of energy or confusion Seizures or loss of consciousness Nausea and vomiting [nlm.nih.gov]

  The headache may be associated with a brief loss of consciousness, seizure, nausea, vomiting, or meningismus. On CT scan, blood is apparent in over 90% of the cases if imaging is performed in the first 24 hours. [cancertherapyadvisor.com]

• Nausea

  Although headache and nausea are common side effects of vardenafil, hemorrhagic diseases should also be considered when symptoms are severe or prolonged. [ncbi.nlm.nih.gov]

• Hypertension

  Abstract BACKGROUND: Cerebral atrium diverticula are focal enlargements of the ventricular system that may develop in the presence of persistent intracranial hypertension, but they are rarely described in cases of acute intracranial hypertension. [ncbi.nlm.nih.gov]

  Is usually a from a cerebral artery aneurysm, trauma or associated with hypertension symptoms of subarachnoid hemorrage usually a sudden on set, headache, buchal rigidity, grossly bloody spinal fluid, focal signs chronic subdural hematomas s/s appear [quizlet.com]

• Diplopia

  A 40-year-old woman with aplastic anemia visited our hospital because of severe headache, nausea, vomiting, blurred vision and diplopia for a period of 1 month. She had taken oxymetholone for 2 years. [ncbi.nlm.nih.gov]

  In 31 out of 35 cases (89%), at least one of the following signs were present (besides headache): vomiting, diplopia, cognitive changes or changes in consciousness level, or focal neurologic signs (i.e., motor deficit or changes in language). [scielo.br]

  The symptoms gradually worsened, and on the day of presentation to an outside hospital emergency department, the patient complained of nausea, vomiting, and diplopia. [ajnr.org]

  The uncommon manifestations of CSDH are: Diplopia. Ataxia. Parkinson's disease. Transient ischaemic attack. The diagnosis of CSDH should be suspected in patients with: Increasing confusion. Recurrent falls. Neurological deficit. [pmj.bmj.com]

  11] In a study of 14 children with intracranial injuries due to spring- or gas-powered BB or pellet guns, 10 of the children required surgery, and 6 were left with permanent neurologic injuries, including epilepsy, cognitive deficits, hydrocephalus, diplopia [emedicine.medscape.com]

• Anisocoria

  The period from losing consciousness to brain herniation presenting as anisocoria was very short-only 30 minutes in our patient. [ncbi.nlm.nih.gov]

  But the CT after 48 hours showed edema around the contusion and uncal herniation with anisocoria (Figure 2(b)). Since the massive contusion in the frontal lobe exerted a mass effect, removal of contusion was considered. [hindawi.com]

  Anisocoria was present in 7.5% of patients on admission. [scielo.br]

  There are often signs of brainstem compression: miosis, mydriasis, nystagmus, anisocoria, flaccid or hypertonic limbs, and eye deviation. [reliasmedia.com]

• Pupillary Abnormality

  Also several studies have shown increased mortality in patients with the presence of pupillary abnormalities, which was seen acutely in our patient. [hindawi.com]

  Most patients (65-80%) present with a severely depressed conscious state, and pupillary abnormalities are seen in ~40% (range 30-50%) of cases 5. [radiopaedia.org]

  Other poor prognostic indicators for acute SDH have been reported to include the initial and postresuscitation Glasgow coma scale (GCS) score, the GCS motor score on admission, pupillary abnormalities, alcohol use, injury by motorcycle, ischemic damage [emedicine.medscape.com]

• Hemianopsia

  Common neurological signs include aphasia, cranial nerve palsies, hemiparesis, hemisensory deficits, gait disturbances, and hemianopsia.19,25,28,62 The majority of subdural hygromas are asymptomatic. [reliasmedia.com]

  Common neurological signs include aphasia, cranial nerve palsies, hemiparesis, hemisensory deficits, gait disturbances, and hemianopsia. 19,25,28,62 The majority of subdural hygromas are asymptomatic. [ahcmedia.com]

• Psychiatric Manifestation

  Psychiatric manifestation of chronic subdural hematoma: the unfolding of mystery in a homeless patient. Indian J Psychol Med 2015; 37(2):239-42. Djoubairou B, Gazzaz M, Dao I, Mostarchid B. (2015). [medigraphic.com]

• Urinary Incontinence

  CASE DESCRIPTION: A 55-year-old man was admitted to our hospital complaining of headache, seizure, and urinary incontinence. He had a history of alcoholism and several hospitalizations for mild head trauma. [ncbi.nlm.nih.gov]

  Case report: 48-year old female patient, ASA I, undergoing spinal anesthesia for surgery to correct urinary incontinence. The spinal anesthesia was performed with 27G Quincke needle and single puncture. [mendeley.com]

  incontinence 0 0 1.1% 2 Source: Discipline of neurosurgery, Surgery Department, Santa Casa de São Paulo (2001-2008). [scielo.br]

• Headache

  Hematoma thickness was significantly greater in patients without headache (P KEYWORDS: Chronic subdural hematoma; Headache; Pressure; Tension; Thickness [ncbi.nlm.nih.gov]

  Twelve hours after the surgery, she developed headache which rapidly became severe and was not relieved by assuming supine posture or with hydration. The severity of headache did not change with the change in the posture. [jdrntruhs.org]

• Seizure

  Seizures often occur at the time the hematoma forms, or up to months or years after treatment. But medicines can help control the seizures. [nlm.nih.gov]

  Chronic SDH may present with headaches, light-headedness, cognitive impairment, and seizures. 1 The risk of posttraumatic epileptic seizures (PTS) is higher in acute SDH. [jetem.org]

  They often require surgery, especially when there are neurologic problems, seizures, or chronic headaches. [pennstatehershey.adam.com]

  Seizures: Damage to the brain from subdural hematomas can lead to seizures. These can usually be controlled with proper treatment. [baptisthealth.com]

  Exclusion criteria History of pre‐existing seizures. [doi.org]

• Confusion

  For example, if you see symptoms of confusion, weakness, or numbness weeks or months after a head injury in an older adult, call the provider right away. [pennstatehershey.adam.com]

  BACKGROUND: The high recurrent rate of chronic subdural hematoma (CSDH) has consistently confused the neurosurgeons, and the role of atorvastatin in the management of CSDH has remained unclear over past decade, and atorvastatin seems to be a safe and [ncbi.nlm.nih.gov]

  Depending on the size of the hematoma and where it presses on the brain, any of the following symptoms may occur: Confused or slurred speech Problems with balance or walking Headache Lack of energy or confusion Seizures or loss of consciousness Nausea [nlm.nih.gov]

  There may be a gradually evolving neurological deficit such as focal limb weakness, speech difficulties, increasing drowsiness/confusion or personality changes. [patient.info]

  ANDY CARSON, 72, ARRIVES at the ED with his daughter, who says her father has had severe headaches and has become increasingly forgetful and confused over the last week. Figure Mr. Carson is confused and disoriented. [journals.lww.com]

• Stroke

  Here, we present the case of a 64 year-old male whose prostate carcinoma's metastasis mimicked a subdural hematoma, and he suffered a middle cerebral artery stroke. [ncbi.nlm.nih.gov]

  Página 311 - The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. ‎ [books.google.es]

  The Neuro-ICU cares for patients with all types of neurosurgical and neurological injuries, including stroke, brain hemorrhage, trauma and tumors. [uclahealth.org]

  Compression of brain tissue results in cerebral ischemia, stroke, brain tissue shift, and brain herniation. [journals.lww.com]

• Lethargy

  […] subdural hematoma include the following: A history of recent head injury Loss of consciousness or fluctuating levels of consciousness Irritability Seizures Pain Numbness Headache (either constant or fluctuating) Dizziness Disorientation Amnesia Weakness or lethargy [neurolaw.com]

  Symptoms include: Headache Weakness or numbness in arms, legs, or face Poor balance or coordination Change in behavior, emotions, or memory Drowsiness, lethargy, or coma Changes in vision Trouble speaking, swallowing, or communicating Nausea/vomiting [sharecare.com]

  Other symptoms include lethargy, memory impairment, confusion, weakness, nausea, vomiting, impaired vision and seizures. Patients with large hematomas may develop varying degrees of paralysis and coma. [uclahealth.org]

  […] symptoms may include: Bulging fontanelles (the soft spots of the baby's skull) Separated sutures (the areas where growing skull bones join) Feeding problems Seizures High-pitched cry, irritability Increased head size (circumference) Increased sleepiness or lethargy [nlm.nih.gov]

  Subdural hematoma symptoms may include: Confused or slurred speech Confusion or changes in behavior Difficulty with balance or walking Dizziness Feeding difficulties (in infants) Headache Increased head circumference (in infants) Irritability (infants) Lethargy [baptisthealth.com]

Following any form of head trauma, medical assessment including complete neurological examination should be conducted on the individual [8]. Most of the time, a CT scan or MRI scan will usually show significant subdural hematomas.

Subdural hematomas are seen mostly around the sides and tops of the parietal and frontal lobes. They are also seen in the posterior cranial fossa as well as near the falx cereberi and tentorium cerebeli. Subdural hematomas can expand along the skull unlike epidural hematomas.

Following a CT scan, subdural hematomas appear crescent-shaped with a concave surface away from the skull. However, they can have a convex appearance especially in the early stage of bleeding.

Abstract Purpose To evaluate the effect of middle meningeal artery (MMA) embolization on chronic subdural hematoma (CSDH) and compare the treatment outcomes of MMA embolization and conventional treatment. [ncbi.nlm.nih.gov]

Yoshimoto Y, Kwak S: Frontal small craniostomy and irrigation for treatment of chronic subdural haematoma. Br J Neurosurg 11:150-151, 1997. [medschool.lsuhsc.edu]

The difference in surgical treatment numbers correlates to skewed results and uncertain interpretation, thus making the choice of optimal surgical treatment more difficult to ascertain. [journals.plos.org]

Mortality for cases of subdural hematoma has been put at 36 to 79% [5]. Most of the time, survivors are not able to regain previous levels of functionality especially following acute subdural hematoma that is serious enough to warrant surgical drainage. Positive outcomes in cases of subdural hematoma is seen 14 to 40% of the time.

Studies show that outcome is often favourable in younger patients [6].

The main causes of acute subdural hematoma may include any of the following [2]:

• Trauma
• Anticoagulation
• Intracranial hemorrhage
• Intracranial hypotension
• Surgery
• Abuse

The main causes of chronic subdural hematoma include the following:

• Mild or severe head trauma
• Acute subdural hematoma following surgey 
• Spontaneous

Risk factors for chronic subdural hematoma include the following:

• Diabetes
• Thrombocytopenia
• Cardiovascular disorder
• Arachnoid cyst
• Epilepsy 
• Alcoholism

Acute subdural hematomas have been noted to occur in 5 to 25% of patients that have severe head injuries with annual cases reported to be 1 to 5.3 cases per 100,000 population [3]. Some of the more recent studies show a higher incidence but this may be as a result of better imaging techniques.

There is sexual preponderance as SDH is seen more in men than in women. Male to female ratio is approximately 3:1. Men equally have a higher incidence of chronic subdural hematoma. The male to female ratio for chronic subdural hematoma is 2:1.

The incidence of chronic subdural hematoma is believed to be at its peak within the fifth to seventh decades of life.

An acute subdural hematoma is a condition arising from a high-speed impact to the skull. This can lead to tearing of intracranial blood vessels [4].

Most of the time, the torn blood vessel is a bridging vein which connects the cortical surface of the brain to a dural sinus. In elderly individuals, the dural sinus may already be stretched due to brain atrophy.

Alternatively, a direct injury or laceration can damage a cortical vessel which may be a vein or artery. Acute subdural hematoma as a result of a ruptured cortical artery may be associated with only a minor head injury possibly without any associated cerebral contusion. Arterial injury may result in rapid neurological decline. In some instances, the ruptured cortical arteries were found located around the sylvian fissure. Generally, low-pressure venous bleeding from bridging veins occurs along the convexity. 

The head trauma may equally also cause associated brain hematomas or contusions as well as subarachnoid hemorrhage or diffusing axonal injury. Secondary brain injuries can include secondary haemorrhage, brain herniation, infarction or edema.

Chronic subdural hematomas develop over a time of days to weeks, often after minor head injury. They may not be discovered until they present clinically after a while.

The best way to prevent SDH is to prevent head trauma by using adequate protective gear when engaging in risky activities [10]. As soon as the head suffers any form of impact, the individual should undergo medical evaluation. All underlying ailments must also be adequately taken care of.

A subdural hematoma (SDH) refers to the collection of blood outside the brain below the dura mater [1]. This condition is generally occurs due to severe head injuries and causes increased bleeding and pressure on the brain. This makes it a life-threatening condition. Subdural hematomas often require surgical drainage but in many cases, they resolve and stop without any external interventions.

Subdural hematoma refers to a situation where a vessle get ruptured between the brain and the dura matter. The dura matter refers to one of the three membrane layers that cover your brain. The leaking blood forms a kind of clot which compresses the tissues of the brain. If the clot (hematoma) continues to enlarge, a progressive decline in consciousness often follows and this often leads to death when untreated. Treatment is mostly via surgery.