Diagnosis and management of subdural hematoma: a review of recent literature

Abstract

Subdural hematoma is extra-cerebral accumulation of blood between the dura matter and the subarachnoid layer. Subdural hematoma can be associated with significant long-term morbidities and high rates of mortality. The mortality following subdural hematoma can be as high as 32%, and recurrence rates can reach 33%. Acute subdural hematoma is an emergency and requires prompt diagnosis using CT most of the time, and management requires surgery as well as reversal of anticoagulants. We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1985, through February 2017. The following search terms were used: emergency management of subdural hematoma, subdural hematoma, CT vs. MRI in diagnosis of subdural hematoma, treatment of subdural hematoma. In this review, our aim is to study the etiology of subdural hematoma and understand how it should be diagnosed and managed. Subdural hematoma are clinical emergencies that require immediate and rapid management to prevent significant morbidity and mortality. They can be grouped into acute, subacute, or chronic, with the acute type being the most dangerous and associated with the highest mortality rates. Subdural hematoma is diagnosed using CT or MRI imaging. Management of a patient with subdural hematoma includes resuscitation followed by control of the bleeding. Controlling intracranial pressure is an important factor for predicting the outcomes of subdural hematoma, and should thus be continuously monitored and corrected.

Intravascular Large Cell non-Hodgkin Lymphoma in Subacute-Chronic Subdural Hematoma: a case report

“…Subdural hematomas can be categorized into acute, subacute, and chronic. Subdural hematoma is said to be acute if it appears within 3 days after bleeding, subacute subdural hematoma appears within four to twenty days after bleeding, and chronic subdural hematoma appears anytime after twenty days of bleeding (Alshora et al, 2018). Asymptomatic and mild cases of SDH can usually be treated medically.…”

“…Recurrent subdural hematomas may also be an indication for surgical intervention when there is re-accumulation of bleeding causing symptoms. In addition, a subdural hematoma larger than 10 mm, a change in mental status and dilatation of both pupils, or an extensor posture requires immediate surgical intervention (Alshora et al, 2018). The recurrence rate of chronic SDH is said to be quite high, in recent decades reaching 33.3%, but many studies show a recurrence rate of 10-15% (Uno et al, 2017).…”

Manajemen Anestesi untuk Evakuasi Perdarahan Subdural Pasien Cedera Otak Traumatik dengan Gagal Ginjal Kronis

“…[5][6][7] Berdasarkan pemeriksaan hemoglobin diketahui pasien mengalami anemia ringan Hb 8,8 mg/dl, hal ini dapat disebabkan oleh penurunan produksi eritropoietin yang diakibatkan oleh penurunan fungsi ginjal. 10,11 Pada pasien ini dengan riwayat gagal ginjal kronis yang akan menjalani operasi perlu dipertimbangkan hemodialisa dan perhitungan creatinine clearance. Perhitungan dapat diperkirakan dengan rumus untuk pria berikut ini: Tabel 2.…”

Delayed Recognition, Surgical Dilemmas, and Complications: A Case Report of Acute-on-Chronic Subdural Hematoma With Ischemic Stroke

“…Subdural hematoma (SDH) is defined as the accumulation of blood between the dura mater and the arachnoid layer [ 1 ]. SDH is categorized into acute, subacute, and chronic based on the time of presentation, with acute presentation occurring within three days and chronic presentation occurring after 20 days [ 1 ]. CSDH is common, especially in the elderly population, with trauma being the most frequent risk factor [ 2 ].…”

“…The presentation of CSDH varies; patients may be asymptomatic or may experience a variety of symptoms such as headache, disorientation, vertigo, or seizures [ 2 ]. The definitive management technique is surgical management; however, some patients may only be observed closely or receive medical management [ 1 , 2 ]. Surgical management includes a twist-drill craniotomy and preferable burr hole evacuation due to fewer complications and a low chance of recurrence [ 2 ].…”