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Acute Subdural Hematoma
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What are the treatments for the injury?
A craniotomy, or brain surgery, is the treatment for acute subdural hematoma. The skull is opened, and the hematoma is removed. The bleeding vein is clotted if it is still bleeding. Often where there is swelling of the brain, the piece of bone is left out. It may be replaced later if the individual recovers enough. This practice can relieve the increased pressure inside the skull that frequently occurs.
Breathing is often controlled with a ventilator, or artificial breathing machine. Fluids and medicines are used to control blood flow in the brain. Anticonvulsant medicines are often used to prevent seizures. Those who recover from surgery may be mildly or severely neurologically impaired. If so, long-term rehabilitation may be necessary. Some survivors are so neurologically impaired that long-term nursing care in a skilled nursing facility may be necessary.
What are the side effects of the treatments?
After surgery, many individuals have neurological impairments. They may have changes in consciousness level, motor skills, and activities of daily living. Seizure disorders are common, requiring medicines for control. The death rate following even the best treatment has been reported to be as high as 80%.
What happens after treatment for the injury?
After treatment, many individuals experience impaired motor coordination. They are at risk for future injuries. Many individuals may have problems with memory, judgment, and attention span. Some of these changes may be permanent. Psychological counseling may be helpful for both the individual and the family. Any new or worsening symptoms should be reported to the healthcare provider.
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Author: James Warson, MD Reviewer: Adam Brochert, MD Date Reviewed: 06/01/01
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