Dangerous Headaches: Subdural Hematoma

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Most headaches are not dangerous so if you have a headache, it’s probably harmless. However, it’s helpful to know the causes of more dangerous headaches just in case.

A subdural hematoma is a type of brain hemorrhage. Bleeding occurs in the space between the outer layer (dura) and middle layers (meninges) of the brain. It is usually caused by bleeding veins in the dura as a result of an impact, such as an accident.

People who are prone to falling over tend to have more hematomas as you don’t need to be hit hard or to suffer a fractured skull. Often, tearing can occur to the veins with a seemingly minor impact.

The pool of blood can enlarge over several weeks, putting pressure on the brain. It can lead to death if the blood is not drained in time.

Smaller subdural hematomas may not be as dangerous as the body can re-absorb small amounts of blood, but you should still seek medical advice if you have any troubling symptoms, as prompt treatment of this condition can prevent brain damage and death.

Symptoms of Subdural Hematoma

• Headache with confusion or drowsiness
• Tiredness
• One-sided weakness or paralysis
• Enlarged pupils
• Convulsions
• Loss of consciousness
• Coma

Babies and children may also become irritable, vomit and have a swollen fontanelle (soft spot on their head).
Symptoms can occur as soon as 48 hours after impact or may not occur until several weeks afterwards.

How Do I Know If My Headache is Dangerous?

A headache is probably dangerous if it starts suddenly and is very severe, if it is different from the type of headache you normally experience, if it starts later on in life (after the age of 50), if you have a fever at the same time and if there are any visual changes such as blurred vision.

Neurological symptoms such as weakness or paralysis are also an indication of a serious headache, as is weight loss and changes in mental state (sleepiness, hallucinations).

Diagnosis

Subdural hematoma is usually diagnosed by MRI scan. The hematoma can be seen on the scan. If the patient has been gradually losing consciousness, this is also a strong indicator of a hematoma.

Treatment

Surgery is the only course of treatment for a subdural hematoma. Holes are drilled in the skull and the blood is drained out through these holes. If the hematoma is large, a portion of skull may be opened to remove it. The surgeon can also tie off the bleeding vein.

Affected adults may suffer headaches, dizziness and lack of concentration for several months after surgery, while they are recovering. They might also develop seizures as a result of the head trauma.

Children can also have the same side effects but they usually get better more quickly.

Sources:

Subdural Hematoma, The Free Dictionary, Medical Dictionary. Web. 19 March 2012.
http://medical-dictionary.thefreedictionary.com/Subdural+bleeding

Headaches, Neurology Muscular Dystrophy and Neuropathy Institute. Web. 19 March 2012.
http://www.beverlyhillsneurology.com/headaches.htm

Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/

She is author of the book, "Breast Milk: A Natural Immunisation", and co-author of an educational resource on disabled parenting.

Reviewed March 19, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.