A subdural hematoma is a collection of blood outside the brain. Subdural hematomas are usually caused by severe head injuries. The bleeding and increased pressure on the brain from a subdural hematoma can be life-threatening. Some subdural hematomas stop and resolve spontaneously; others require surgical drainage.
What Is a Subdural Hematoma?
In a subdural hematoma, blood collects between the layers of tissue that surround the brain. The outermost layer is called the dura. In a subdural hematoma, bleeding occurs between the dura and the next layer, the arachnoid.The bleeding in a subdural hematoma is under the skull and outside the brain, not in the brain itself. As blood accumulates, however, pressure on the brain increases. The pressure on the brain causes a subdural hematoma's symptoms. If pressure inside the skull rises to very high level, a subdural hematoma can lead to unconsciousness and death.
Symptoms of Subdural Hematoma
Symptoms of subdural hematoma depend mostly on the rate of bleeding:
- In head injuries with sudden, severe bleeding causing a subdural hematoma, a person may lose consciousness and become comatose immediately.
- A person may appear normal for days after a head injury, but slowly become confused and then unconscious several days later. This results from a slower rate of bleeding, causing a slowly enlarging subdural hematoma.
- In very slow-growing subdural hematomas, there may be no noticeable symptoms for more than two weeks after the bleeding starts.
- Headache
- Confusion
- Change in behavior
- Dizziness
- Nausea and vomiting
- Lethargy or excessive drowsiness
- Weakness
- Apathy
- Seizures
Causes of Post-Concussion Syndrome
In general, post-concussion syndrome follows the occurrence of an injury or trauma to the head. Not all people who suffer mild traumatic head injury experience post-concussion syndrome. This syndrome may be worse in people who have had previous concussions or head trauma. It may also be more severe in those who have early symptoms of headache after injury, or who have mental changes such as amnesia, fogginess or fatigue. Other risk factors include younger age and prior history of headaches.Diagnosis of Post-Concussion Syndrome
Since symptoms can be vague and attributable to other reasons, it can be difficult to diagnose post-concussion syndrome. There is no definitive test for post-concussion syndrome. Diagnosis is mainly based on a history of head injury and reported symptoms. A physical exam, and perhaps a CT or MRI scan of the head, may be done to evaluate symptoms. Other tests may be given to rule out other causes of symptoms, such as infection, bleeding injury to the brain, or poisoning.Symptoms of Post-Concussion Syndrome
Symptoms of post-concussion syndrome are often vague and non-specific.Commonly reported symptoms include:
- Headache
- Dizziness
- Sleep problems
- Psychological symptoms such as depressed mood, irritability, and anxiety
- Cognitive problems involving memory, concentration, and thinking
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