Chronic subdural hematomas are defined as the accumulation of blood in the potential space between the outermost layer of the brain, called the dura mater, and the middle layer, known as the arachnoid mater. This condition occurs over a prolonged period, typically more than three weeks, following a head injury or trauma, but can also develop spontaneously in individuals without any apparent history of trauma.
Chronic subdural hematomas often result from venous tear or rupture of blood vessels that bridge the brain's surface and its underlying structures, leading to the collection of blood between the layers of the meninges. This accumulation causes pressure on the brain tissue, leading to various symptoms, ranging from mild to severe, depending on the size and location of the hematoma.
Common symptoms of chronic subdural hematomas may include headaches, confusion, memory problems, dizziness, slurred speech, weakness, seizures, and difficulty with coordination. Elderly individuals and those with a history of alcohol abuse or underlying medical conditions, such as liver disease or clotting disorders, are at an increased risk of developing chronic subdural hematomas.
Diagnosis of chronic subdural hematomas typically involves a thorough clinical examination, imaging tests like computed tomography (CT) or magnetic resonance imaging (MRI), and sometimes, a neurological evaluation, which can help determine the severity and location of the hematoma. Treatment options may vary depending on the size of the hematoma and the patient's overall health, and may include conservative management with observation, medications, non-surgical drainage, or surgical intervention, such as burr hole evacuation or craniotomy, to remove the accumulated blood and relieve pressure on the brain.
