Materiały źródłowe

• #1 Subdural Hematoma: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1137207-overview

  A subdural hematoma (SDH) is a collection of blood below the inner layer of the dura but external to the brain and arachnoid membrane. Subdural hematoma is the most common type of traumatic intracranial mass lesion. […] SDH occurs not only in patients with severe head injury but also in patients with less severe head injuries, particularly those who are elderly or who are receiving anticoagulants. SDH may also be spontaneous or caused by a procedure, such as a lumbar puncture. […] Significant trauma is not the only cause of SDH. Chronic SDH can occur in the elderly after apparently insignificant head trauma. […] Causes of acute SDH include head trauma, coagulopathy or medical anticoagulation, nontraumatic intracranial hemorrhage due to cerebral aneurysm, arteriovenous malformation, or tumor, postsurgical causes, intracranial hypotension, child abuse or shaken baby syndrome, and spontaneous or unknown causes.

• #2

  https://www.nhs.uk/conditions/subdural-haematoma/

  A subdural haematoma occurs when a blood vessel in the space between the skull and the brain (the subdural space) is damaged. […] Blood escapes from the blood vessel, leading to the formation of a blood clot (haematoma) that places pressure on the brain and damages it. […] Head injuries that cause subdural haematomas are often severe, such as those from a car crash, fall or violent assault. […] But minor bumps to the head can also lead to a subdural haematoma in a few cases. […] A minor head injury is more likely to lead to a subdural haematoma if you’re over 60, taking anticoagulant („blood-thinning”) medicine or have a history of alcohol misuse.

• #3 Subdural Hematoma: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21183-subdural-hematoma

  A subdural hematoma is a type of bleeding inside your head. It happens when blood collects under the dura mater, one of the layers of tissue that protect your brain. It most often happens from a head injury and can be fatal. […] A subdural hematoma develops from a tear in a blood vessel. Blood leaks out of the torn vessel into the space between your dura mater and your arachnoid mater. Active bleeding into this space is called a subdural hemorrhage. A buildup of blood is a subdural hematoma. […] What causes subdural hematomas? Head injuries cause most subdural hematomas. Examples of how this could happen include: Falling and hitting your head. Taking a blow to your head in a car or bike accident. Hitting your head while playing sports. Getting a head injury from an assault or physical abuse.

• #4 Subdural hematoma – Wikipedia

  https://en.wikipedia.org/wiki/Subdural_hematoma

  Subdural hematomas are most often caused by head injury, in which rapidly changing velocities within the skull may stretch and tear small bridging veins. […] They are also commonly seen in the elderly and in people with an alcohol use disorder who have evidence of cerebral atrophy. […] Another cause can be a reduction in cerebrospinal fluid pressure, which can reduce pressure in the subarachnoid space, pulling the arachnoid away from the dura mater and leading to a rupture of the blood vessels. […] Factors increasing the risk of a subdural hematoma include very young or very old age. […] Other risk factors include taking blood thinners (anticoagulants), long-term excessive alcohol consumption, dementia, and cerebrospinal fluid leaks.

• #5 Subdural Haematoma: Symptoms and Treatment | Doctor

  https://patient.info/doctor/subdural-haematoma-pro

  A subdural haematoma (SDH) is a collection of clotting blood that forms in the subdural space. This may be: […] An acute SDH is usually caused by either: […] Tearing of bridging veins from the cortex to one of the draining venous sinuses – typically occurring when bridging veins are sheared during rapid acceleration-deceleration of the head. […] Blunt head trauma is the usual mechanism of injury but spontaneous SDH can arise as a consequence of clotting disorder, arteriovenous malformations/aneurysms or other conditions. […] In the subacute phase the collection of clotted blood liquifies. In the chronic phase it becomes a collection of serous fluid in the subdural space. […] Cerebral atrophy can occur in people over the age of 60, causing tension on the veins, which may also be weaker and more susceptible to injury as a consequence of age.

• #6

  https://www.nhs.uk/conditions/subdural-haematoma/causes/

  Subdural haematomas are usually caused by a head injury. […] Head injuries that cause subdural haematomas are often severe, such as from a car crash, fall or violent assault. […] Minor bumps to the head can also lead to a subdural haematoma in a few cases. […] A subdural haematoma develops if there’s bleeding into the space between the skull and the brain (the subdural space) caused by damage to the blood vessels of the brain or the brain itself. […] Chronic subdural haematomas form gradually a few weeks after a minor head injury. […] These are more commonly seen in older people and those who take anticoagulant („blood-thinning”) medicine, drink excessively, or have another medical condition. […] Most chronic subdural haematomas affect people over 60, and the chances of developing one increase with age.

• #7 Subdural Hematoma: Causes, Types, Symptoms, Risks & Recovery

  https://www.webmd.com/brain/subdural-hematoma-symptoms-causes-treatments

  Subdural hematomas are usually caused by a head injury from a fall, motor vehicle collision, or an assault. The sudden blow to the head tears blood vessels that run along the surface of the brain. This is referred to as an acute subdural hematoma. […] People who play contact sports, such as (American) football, boxing, or mixed martial arts (MMA) are especially at risk for this condition. Newborn infants are also at risk, as their skulls are still soft and pliable. They may experience subdural hematoma as a result of a traumatic birth or in cases of shaken baby syndrome. […] People with a bleeding disorder or those who take blood thinners are also more likely to develop a subdural hematoma. A relatively minor head injury can cause the condition in people with a bleeding tendency. Finally, people with alcohol use disorder have a higher risk of developing a subdural hematoma, as alcohol can cause the brain to shrink, weakening the blood vessels in the tissues surrounding it.

• #8 Chronic Subdural Hematoma Thousand Oaks, CA | Vascular Neurology Southern California

  https://www.vnsc.org/procedures/chronic-subdural-hematoma/

  Subdural hematomas occur due to blood collecting between the surface of the brain and its outer covering. […] While there are different types of subdural hematomas that can be caused by minor to severe head injuries, they all require immediate treatment as their symptoms develop. […] A chronic subdural hematoma forms from older blood clots that liquify beneath the outer covering and the surface of the brain. […] Often, chronic subdural hematomas occur in elderly people, age 60 and older, who have brain atrophy or shrinking of the brain, and experience minor head injuries. […] As the brain shrinks due to age or disease, the subdural space grows, making it more likely for blood vessels to break. […] The most common causes of chronic subdural hematoma are from head injuries caused by accidents, falls, blows to the head, or other traumatic events. […] While age is a significant factor for developing chronic subdural hematoma, affecting the very young and the elderly, other considerations that increase risks include taking anticoagulant medication, such as blood thinners, aspirin, or anti-inflammatory drugs like ibuprofen.

• #9 Subdural hematoma : MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000713.htm

  A subdural hematoma is most often the result of a severe head injury. This type of subdural hematoma is among the deadliest of all head injuries. The bleeding fills the brain area very rapidly, compressing brain tissue. This often results in brain injury and may lead to death. […] With any subdural hematoma, tiny veins between the surface of the brain and its outer covering (the dura) stretch and tear, allowing blood to collect. In older adults, the veins are often already stretched because of brain shrinkage (atrophy) and are more easily injured. […] A chronic subdural hematoma is more often seen in older adults. This type of subdural hematoma may be due to blood that persists after an acute injury or the result of slowly leaking blood. These can occur after a minor head injury and may go unnoticed for many days.

• #10 Subdural Hematoma: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21183-subdural-hematoma

  Age: People 65 and older and babies are more at risk for getting subdural hematomas. As you age, your brain shrinks inside your skull. The space between your skull and brain widens. This makes the tiny veins in the membranes between your skull and brain stretch. These thinned, stretched veins are more likely to tear, even if you experience a minor head injury. Babies dont have strong neck muscles to protect themselves from head trauma. When someone shakes a baby forcefully, they can develop a subdural hematoma (shaken baby syndrome). […] Playing contact sports: People who play high-impact or extreme sports (like football, rugby or snowboarding) have an increased risk of a subdural hematoma. […] Taking blood thinners: Blood thinners (anticoagulants) slow down your clotting process or prevent blood from clotting at all. If your blood doesnt clot, bleeding around your brain can be severe and long-lasting, even after a relatively minor injury.

• #11 Subdural Hematoma: Causes, Types, Symptoms, Risks & Recovery

  https://www.webmd.com/brain/subdural-hematoma-symptoms-causes-treatments

  In a chronic subdural hematoma, small veins on the outer surface of the brain may tear, causing bleeding in the subdural space. Symptoms may not show up for several days or weeks. […] Elderly people are at a higher risk for chronic subdural hematoma because natural age-related brain shrinkage causes these tiny veins to stretch and become more vulnerable to tearing.

• #12

  https://www.nhs.uk/conditions/subdural-haematoma/causes/

  This is thought to be because most people’s brains shrink to some degree as they get older. […] Drinking too much alcohol over a long period of time can also gradually cause the brain to shrink and make the brain’s blood vessels more vulnerable to damage. […] Taking medicine to reduce your risk of blood clots can increase your risk of developing a chronic subdural haematoma. […] This is because it means your blood clots less easily and any bleeding caused by a head injury is likely to be more severe. […] An increased risk of chronic subdural haematoma has also been linked with epilepsy a condition that causes repeated fits (seizures), haemophilia a condition that stops your blood clotting properly, having a ventriculoperitoneal shunt a thin tube implanted in the brain to drain away any excess fluid to treat hydrocephalus, brain aneurysms a bulge in one of the brain’s blood vessels that can burst and cause bleeding on the brain, cancerous (malignant) brain tumours.

• #13 Chronic subdural hematoma Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/chronic-subdural-hematoma

  A subdural hematoma develops when bridging veins tear and leak blood. These are the tiny veins that run between the dura and surface of the brain. This is usually the result of a head injury. […] A subdural hematoma is more common in older adults because of normal brain shrinkage that occurs with aging. This shrinkage stretches and weakens the bridging veins. These veins are more likely to break in older adults, even after a minor head injury. […] Risks include: Long-term heavy alcohol use, Long-term use of aspirin, anti-inflammatory medicines such as ibuprofen, or blood thinning (anticoagulant) medicine such as warfarin, Diseases that lead to reduced blood clotting, Head injury, Old age.

• #14 Subdural Hematoma in Brain for Newborn | Infant & Baby Subdural Hematoma Treatment

  https://www.abclawcenters.com/practice-areas/subdural-hemorrhages-hematomas/

  A lack of oxygen to the baby’s brain during or near the time of delivery can place a baby at risk of having a subdural hemorrhage. However, trauma to the head is a more common cause of this type of bleed. […] Risk factors for and causes of a subdural hemorrhage include the following: Oxygen deprivation/hypoxic-ischemic encephalopathy (HIE), Use of forceps or vacuum extractors to facilitate delivery, A vaginal delivery when the baby is in breech presentation, Improperly managed brow or face presentation, Macrosomic (unusually large) baby, Cephalopelvic disproportion (CPD), Precipitous delivery, Prolonged labor and delivery.

• #15 Subdural Hematoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532970/

  A subdural hematoma, as its name implies, forms because of an abnormal collection of blood under the dura mater. This is one of the intracranial injuries associated with abusive head trauma, especially in pediatric patients. […] In the pediatric patient, trauma is the most common cause of subdural hematoma. Contributing factors include blunt and shearing injuries. Cranium extraction device use and traumatic birth delivery accounts for a majority of the SDH in the newborn period. […] However, after the newborn period until age 2 years, the cause of SDH is predominantly due to accidental injury or intentional head injury. SDH due to intentional injury is frequently referred to as „shaken baby syndrome.” The term correlates with the back-and-forth motion of the brain in the skull, held by the fragile bridging veins that rupture after violent, repeated movements against the inertia of the brain.

• #16 Subdural Hematoma – baby, symptoms, Definition, Description, Demographics, Causes and symptoms, Diagnosis

  http://www.healthofchildren.com/S/Subdural-Hematoma.html

  A subdural hematoma is a collection of blood in the space between the outer and middle layers of the covering of the brain. It is most often caused by torn, bleeding veins as a result of a head trauma. […] Subdural hematomas usually occur because veins on the inside of the dura that connect the brain cortex and the venous sinuses (bridging veins) are ruptured as the result of a blow to the head. […] Subdural hematoma is often seen in physical child abuse. Its presence is one of the defining parameters (along with retinal hemorrhage) of shaken baby syndrome. […] In older children, a fall in which they hit their head is a common cause of subdural hematoma. […] All age groups are susceptible to developing subdural hematomas from vehicle accidents. […] In young children, even if the head does not contact a solid surface, the shaking, whiplash movement from some vehicle crashes causes blood vessels to burst in the brain. […] Preventing blunt head trauma from falls, child abuse, and assaults is the most effective way of preventing subdural hematoma.

• #17 Subdural hematoma : MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000713.htm

  Some subdural hematomas occur without cause (spontaneously). […] The following increase the risk for a subdural hematoma: Medicines that thin the blood (such as warfarin or aspirin), Long-term alcohol use, Medical conditions that make your blood clot poorly, Repeated head injury, such as from falls, Very young or very old age. […] In infants and young children, a subdural hematoma may occur after child abuse and are commonly seen in a condition called shaken baby syndrome.

• #18 Subdural Hematoma: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1137207-overview

  Causes of chronic SDH include head trauma, acute subdural hematoma, and spontaneous or idiopathic causes. Risk factors for chronic SDH include chronic alcoholism, epilepsy, coagulopathy, arachnoid cysts, anticoagulant therapy, cardiovascular disease, thrombocytopenia, and diabetes mellitus. […] In younger patients, alcoholism, thrombocytopenia, coagulation disorders, and oral anticoagulant therapy have been found to be more prevalent. Arachnoid cysts are more commonly associated with chronic SDH in patients younger than 40 years. In older patients, cardiovascular disease and arterial hypertension are found to be more prevalent.

• #19 Subdural hematoma: Definition, treatment, and outlook

  https://www.medicalnewstoday.com/articles/320259

  Sometimes, subdural hematomas may occur spontaneously as a result of another medical condition. […] Risk factors that increase a persons chances of developing subdural hematoma include: blood thinners, such as warfarin or aspirin; medical conditions that cause blood clotting issues; long-term alcohol use or abuse; repeated head injuries, such as from falls or sports; very young or very old age.

• #20 Chronic subdural haematoma (cSDH) | CUH

  https://www.cuh.nhs.uk/patient-information/chronic-subdural-haematoma-csdh/

  A common idea is that an injury to the head has caused a bleed in the subdural space. The body has then failed to reabsorb this blood and instead sealed it off within a membrane, which slowly draws in fluid. […] It is unlikely this is a complete explanation as only two in three people can remember having any head injury prior to their cSDH and even amongst those who did, only one in three will have fresh blood (an acute subdural haematoma) in their subdural space on a brain scan at the time. […] Certain groups of patients are more at risk for cSDH. These include: patients taking medication to thin their blood (eg warfarin, apixaban, edoxaban, aspirin or clopidogrel), older patients, patients unsteady on their feet with increased likelihood of falling, patients with liver disease making them more likely to bleed or bruise, patients with haematological disease and/or clotting disorders, patients who drink alcohol to excess.

• #21 Subdural Hematoma: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21183-subdural-hematoma

  Hemophilia: This is an inherited bleeding disorder that prevents your blood from clotting. People with hemophilia have a higher risk of uncontrolled bleeding after an injury. […] Alcohol use disorder: Drinking excessive amounts of alcohol causes liver damage over time. A damaged liver cant produce enough of the proteins that help your blood clot. This increases your risk of uncontrolled bleeding.

• #22 Subdural Hematoma | Top Neuro Docs

  https://www.topneurodocs.com/subdural-hematoma/

  Causes of chronic subdural hematoma include the following: Head trauma (may be relatively mild, e.g., in older individuals with cerebral atrophy), Acute subdural hematoma, with or without surgical intervention, Spontaneous or idiopathic. […] Risk factors for chronic subdural hematoma include the following: Chronic alcoholism, Epilepsy, Coagulopathy, Arachnoid cysts, Anticoagulant therapy (including aspirin), Cardiovascular disease (e.g., hypertension, arteriosclerosis), Thrombocytopenia, Diabetes mellitus.

• #23 Subdural Hematoma Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/1137207-clinical

  Acute traumatic SDH often results from falls, violence, or motor vehicle accidents. […] Therefore, older patients appear to be at greater risk for developing an acute SDH after head injury. This is believed to stem from older patients having more brain atrophy, which allows more shear force against bridging veins immediately after impact. […] One quarter to one half of patients with chronic SDH have no identifiable history of head trauma. If a patient does have a history of head trauma, it is usually mild. […] Any degree or type of coagulopathy should heighten suspicion of SDH. Hemophiliacs can develop SDH after seemingly trivial head trauma. […] Alcoholics are prone to thrombocytopenia, prolonged bleeding times, and blunt head trauma. […] Patients on anticoagulants can develop SDH with minimal trauma and warrant a lowered threshold for obtaining a head CT scan.

• #24 Subdural hemorrhage | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/subdural-hemorrhage-2?lang=us

  Subdural hematomas, most frequently due to trauma, are seen in all age groups although etiology will vary: […] In addition to trauma, there are numerous other far less common causes: intracranial hypotension, glutaric aciduria type 1 (infants and children, rare), vascular malformations (all ages) and intracranial aneurysms.

• #25 Subdural Hematoma | Top Neuro Docs

  https://www.topneurodocs.com/subdural-hematoma/

  Subdural hematoma occurs not only in patients with severe head injury but also in patients with less severe head injuries, particularly those who are elderly or who are receiving anticoagulants. […] Significant trauma is not the only cause of subdural hematoma. Chronic subdural hematoma can occur in the elderly after apparently insignificant head trauma. […] Causes of acute subdural hematoma include the following: Head trauma, Coagulopathy or medical anticoagulation (e.g., warfarin [Coumadin], heparin, hemophilia, liver disease, thrombocytopenia), Nontraumatic intracranial hemorrhage due to cerebral aneurysm, arteriovenous malformation, or tumor (meningioma or dural metastases), Postsurgical (craniotomy, CSF shunting), Intracranial hypotension (e.g., after lumbar puncture, lumbar CSF leak, lumboperitoneal shunt, spinal epidural anesthesia), Child abuse or shaken baby syndrome (in the pediatric age group), Spontaneous or unknown (rare).

• #26 < ?php wp_title( '|', true, 'right' ); ?>

  https://surgicalneurologyint.com/surgicalint-articles/idiopathic-spontaneous-bilateral-subdural-hematoma-in-a-28-year-old-male-a-comprehensive-literature-review-and-case-report/

  Subdural hematoma (SDH) is considered spontaneous in the absence of trauma history. […] Most cases have a known underlying etiology that explains the incidence, otherwise, they are considered idiopathic. […] With the absence of any pathology that would explain the presentation after extensive investigations, we hypothesized that a sudden rise in vascular pressure was the underlying etiology, especially with the fact that the symptoms became unbearable after the neck chiropractor therapy session. […] It has been suggested that spontaneous chronic SDH occurs due to trivial head injury in the presence of other cofactors such as brain atrophy, systemic hypertension, coagulopathy, alcohol consumption, anticoagulant medications, and intracranial hypotension. […] The underlying pathophysiology is still not clearly understood; however, the anatomical nature of the bridging veins makes them more susceptible to rupture, as they lack the presence of any supporting reinforcement from the arachnoid in addition to their structural lack of elastic or muscular layers.

• #27 Chronic Subdural Haematoma

  https://www.healthhub.sg/a-z/diseases-and-conditions/chronic_subdural_haematoma_nni

  Chronic subdural haematoma (CSDH) is a neurological condition that refers to a collection of blood and blood breakdown products between the surface of the brain and its outermost covering (dura). […] A subdural haematoma develops when these veins tear and leak blood, usually as the result of a head injury. […] Trauma to the brain from a head injury is the most common cause of CSDH. […] In rare cases, a subdural haematoma can occur spontaneously without there being an accident or injury. […] People who have used blood thinning medications such as aspirin or who have diseases associated with blood clotting problems are also at risk of developing CSDH.

• #28

  https://continentalhospitals.com/diseases/subdural-hemorrhage/

  Certain medical conditions and medications can also increase the risk of developing a subdural hemorrhage. For instance, individuals with bleeding disorders or those taking anticoagulant medications may experience prolonged bleeding after head trauma, leading to the accumulation of blood in the subdural space. […] It’s worth noting that sometimes no specific cause can be identified for a subdural hemorrhage. In such cases, it may be attributed to spontaneous bleeding from small blood vessels within the brain. Understanding these various causes of subdural hemorrhage allows healthcare professionals to take appropriate preventive measures for those at risk and provide targeted treatment for individuals who develop this condition.

• #29 Glioblastoma Presenting as Spontaneous Subdural Hematoma

  https://www.thenerve.net/journal/view.php?number=240

  A SDH is most often the result of trauma. Rarely, there are patients who suffer SDH without a definitive history of head trauma. Nontraumatic or spontaneous SDH is rare and many causes should be considered. The etiology of non-traumatic SDH includes cortical aneurysmal rupture, neoplasm, and spontaneous intracranial hypotension. […] A broad cause of spontaneous SDH should be considered including vascular and even neoplastic origin. […] The known vascular origins of non-traumatic SDH are ruptures of small cortical arteries or intracranial aneurysms, rupture of arteriovenous malformation (AVM), and hypertensive or amyloid angiopathic intracerebral hematoma (ICH) perforating the brain surface and arachnoid membrane. […] Spontaneous intracranial hypotension (SIH) is another well-known cause of non-traumatic SDH.

• #30 Acute Subdural Hematoma – OpenAnesthesia

  https://www.openanesthesia.org/keywords/acute-subdural-hematoma/

  Subdural hematoma (SDH) is a type of intracranial hemorrhage characterized by bleeding that occurs between the dural and arachnoid membranes surrounding the brain. […] Trauma is the most common cause of SDH. […] Acute SDH results from head trauma about 70% of the time. […] Minor injuries can result in acute SDH in at-risk patients, such as older patients or patients on anticoagulation. […] Nonaccidental trauma is the typical etiology of acute SDH in infants and children. Concern for abuse should remain high. […] Decreased intracranial pressure (ICP) or intracranial hypotension is another mechanism of acute SDH. […] Any cause of arterial hemorrhage can also lead to SDH, including: intracerebral hemorrhage, ruptured aneurysm, arteriovenous malformations, vasculopathy. […] SDH can also be the result of an underlying malignancy.

• #31 Subdural Hematoma – Free Sketchy Medical Lesson

  https://www.sketchy.com/medical-lessons/subdural-hematoma

  A subdural hematoma is a collection of blood between the dura and arachnoid space secondary to the rupture of bridging veins. This trauma commonly occurs in cases such as falls in the elderly and alcoholics, non-accidental injuries in pediatric patients (such as shaken baby syndrome), or iatrogenic causes like a CSF leak following a lumbar puncture or epidural placement. […] A subdural hematoma is a collection of blood between the dura and arachnoid space due to the tearing of bridging veins. This can occur due to several reasons, the most common being trauma secondary to falls especially in elderly and alcoholics. Non-accidental injuries (like shaken baby syndrome) in pediatric patients is also another cause. Some iatrogenic causes– like a CSF leak following a lumbar puncture or epidural placement– can lead to decreased intracranial pressure which can direct stress the bridging veins and cause them to tear as a result.

• #32 Glioblastoma Presenting as Spontaneous Subdural Hematoma

  https://www.thenerve.net/journal/view.php?number=240

  However, non-traumatic SDH associated with neoplasm is believed to occur rarely and has several pathogenesis including hemorrhagic effusion from malignant tissue, dural vessel obstruction by neoplastic cells, angio-demoplastic reaction of the dura to tumor infiltration, and direct hematogenous metastasis of malignant tumor. […] Oligodendroglioma or GBM primary intracranial tumors are often reported to be associated with hemorrhage.

• #33 Pathophysiology of chronic subdural haematoma: inflammation, angiogenesis and implications for pharmacotherapy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5450087/

  Chronic subdural haematoma (CSDH) is an encapsulated collection of blood and fluid on the surface of the brain. Historically considered a result of head trauma, recent evidence suggests there are more complex processes involved. Trauma may be absent or very minor and does not explain the progressive, chronic course of the condition. […] It has been hypothesised that inflammation is a key factor in the development of a CSDH. This is not a new concept and indeed one of the earliest reports by Virchow in 1857, referred to the condition as pachymeningitis haemorrhagica interna. […] The large number of reports linking CSDH to trauma clouded this early insight regarding inflammation and led to the popular view that CSDH was an entirely traumatic condition. However, some authors did recognise that inflammation and trauma may be co-existing factors in CSDH development and that the trauma need only be very trivial.

• #34 Pathophysiology of chronic subdural haematoma: inflammation, angiogenesis and implications for pharmacotherapy | Journal of Neuroinflammation | Full Text

  https://jneuroinflammation.biomedcentral.com/articles/10.1186/s12974-017-0881-y

  Chronic subdural haematoma (CSDH) is an encapsulated collection of blood and fluid on the surface of the brain. Historically considered a result of head trauma, recent evidence suggests there are more complex processes involved. Trauma may be absent or very minor and does not explain the progressive, chronic course of the condition. […] It has been hypothesised that inflammation is a key factor in the development of a CSDH. This is not a new concept and indeed one of the earliest reports by Virchow in 1857, referred to the condition as pachymeningitis haemorrhagica interna. […] The large number of reports linking CSDH to trauma clouded this early insight regarding inflammation and led to the popular view that CSDH was an entirely traumatic condition. However, some authors did recognise that inflammation and trauma may be co-existing factors in CSDH development and that the trauma need only be very trivial.

• #35 Subdural Hematoma

  https://fpnotebook.com/Neuro/CV/SbdrlHmtm.htm

  Represents 30% of Traumatic Intracranial Hemorrhage causes […] Severe Closed Head Injury […] Rapid Deceleration Injury […] Cranial Trauma results in Subdural Hemorrhage […] Tear of bridging veins between Dura Mater and the arachnoid membrane on the surface of the brain […] Sudden acceleration-deceleration is typical cause.

• #36

  https://step2.medbullets.com/neurology/120300/subdural-hematoma

  A 76-year-old man presents to the emergency department with increasing somnolence and lethargy. His symptoms developed on the day of admission. His symptoms are associated with a headache with mild nausea but no vomiting. He tripped over a carpet and hit his head on the floor. A head CT without contrast demonstrates a crescent-shaped hyperdensity that crosses the suture lines. […] Risk factors include cerebral atrophy, which can be seen in aging, chronic alcohol use, and previous traumatic brain injury. […] Head injury results in tearing of the bridging veins. […] Surgical evacuation is the treatment of choice in symptomatic (e.g., cranial nerve palsies, midline shift, and symptoms of increased intracranial pressure) subdural hematomas.

• #37 Subdural hematoma | Mechanism, Symptoms, & Management | Britannica

  https://www.britannica.com/science/subdural-hematoma

  subdural hematoma, bleeding into the space between the brain and its outermost protective covering, the dura. It typically results when a traumatic force applied to the head creates significant fast-changing velocities of the contents inside the skull. […] A network of veins traverses the space between the surface of the brain and the dura. These veins, the bridging veins, can tear if the contents of the skull experience sudden changes in velocity. Blood leaking from the bridging veins then collects in the subdural space, creating a hematoma. […] Any process that increases the distance that the bridging veins must travel to cross the subdural space increases the risk of tearing and, therefore, of hematoma formation. Brain atrophy is probably the biggest contributor of increased risk. Subdural hematomas, therefore, become more common as people age and the brain undergoes the natural process of age-related atrophy. […] While brain atrophy increases the risk of developing a subdural hematoma, it also decreases the speed and severity of the related symptoms.

• #38 Pathophysiology of chronic subdural haematoma: inflammation, angiogenesis and implications for pharmacotherapy | Journal of Neuroinflammation | Full Text

  https://jneuroinflammation.biomedcentral.com/articles/10.1186/s12974-017-0881-y

  Many animal studies have shown that the presence of blood alone, in the subdural space, is not sufficient to initiate progression to a CSDH, although these models are limited by the nature that animals do not have other contributing factors found in human patients, such as cerebral atrophy. […] Whilst inflammation can aid tissue repair, it is the sustained inflammatory response in CSDH which results in new membrane growth and fluid accumulation over time. […] Importantly, CSDH membranes also contain numerous highly permeable capillaries with thin walls containing thin or absent basement membrane and lacking smooth muscle cells and pericytes. […] The inflammatory process involved in CSDH membrane and fluid formation is localised to the subdural space, exemplified by the fact that the mediators are consistently significantly higher in and around the CSDH compared with peripheral blood.

• #39 Pathophysiology of chronic subdural haematoma: inflammation, angiogenesis and implications for pharmacotherapy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5450087/

  Many animal studies have shown that the presence of blood alone, in the subdural space, is not sufficient to initiate progression to a CSDH, although these models are limited by the nature that animals do not have other contributing factors found in human patients, such as cerebral atrophy. […] However, we do know this to be true in humans as well, as shown by a study on 38 acute subdural haematoma patients where only eight (21%) progressed to form CSDHs. Therefore, it is clear there is more to this condition than trauma causing bleeding into the subdural space. […] Whilst inflammation can aid tissue repair, it is the sustained inflammatory response in CSDH which results in new membrane growth and fluid accumulation over time. […] Importantly, CSDH membranes also contain numerous highly permeable capillaries with thin walls containing thin or absent basement membrane and lacking smooth muscle cells and pericytes.

• #40 Pathophysiology of chronic subdural haematoma: inflammation, angiogenesis and implications for pharmacotherapy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5450087/

  The inflammatory process involved in CSDH membrane and fluid formation is localised to the subdural space, exemplified by the fact that the mediators are consistently significantly higher in and around the CSDH compared with peripheral blood. […] Overall, it is clear that there are multiple drivers promoting expansion of a CSDH. Following trauma, which is often minor and not always evident, there appears to be a complex process of interrelated mechanisms including inflammation, membrane formation, angiogenesis and fibrinolysis that propagate an increase in CSDH volume.

• #41 Pathophysiology of chronic subdural haematoma: inflammation, angiogenesis and implications for pharmacotherapy | Journal of Neuroinflammation | Full Text

  https://jneuroinflammation.biomedcentral.com/articles/10.1186/s12974-017-0881-y

  Overall, it is clear that there are multiple drivers promoting expansion of a CSDH. Following trauma, which is often minor and not always evident, there appears to be a complex process of interrelated mechanisms including inflammation, membrane formation, angiogenesis and fibrinolysis that propagate an increase in CSDH volume.

• #42

  https://www.aurorahealthcare.org/services/neuroscience/brain-skull-base-care/brain-hemorrhage/subdural-hemorrhage

  A subdural hemorrhage is commonly caused by a head injury from things such as a fall, car crash or blow to the skull. […] A subdural hemorrhage is a serious medical condition where blood collects beneath the dura mater, the outermost membrane surrounding the brain. […] Subdural hematomas are classified into one of two types: acute or chronic. […] Acute subdural hemorrhage: A rapidly developing brain bleed, often caused by a significant head injury like a car accident or fall. […] Chronic subdural hemorrhage: A slow-growing hematoma, frequently observed in older adults or individuals with risk factors like blood thinners or alcohol abuse.

• #43 Subdural hematoma Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/subdural-hematoma.html

  A subdural hematoma occurs when a blood vessel near the surface of the brain bursts. Blood builds up between the brain and the brain’s tough outer lining. The condition is also called a subdural hemorrhage. […] Most subdural hemorrhages result from trauma to the head. The trauma damages tiny veins within the meninges. […] In young, healthy people, bleeding usually is triggered by a significant impact. This type of impact might occur in a high-speed motor vehicle accident. […] In contrast, older people may bleed after only a minor trauma. For example, it might happen from falling out of a chair. […] A subdural hematoma is also more common in people taking medications that thin the blood, who abuse alcohol, or who have seizures. […] An acute subdural hemorrhage is bleeding that develops shortly after a serious blow to the head. […] When bleeding develops slowly, it is known as a chronic subdural hemorrhage. […] This form of bleeding is much more common in older people. The head trauma that causes chronic subdural hemorrhage is often minor. Many of those affected cannot recall a head injury.

• #44 What Is a Subdural Hemorrhage?

  https://www.rwjbh.org/treatment-care/neuroscience/neurology/conditions/subdural-hemorrhage/

  A subdural hemorrhage can be acute, subacute, or chronic. […] Subdural hemorrhages are usually caused by a head injury. If you bump your head in a fall or an accident, its important to be assessed by a medical professional. Activities that are highly likely to cause a serious head injury include high-impact sports and car crashes. […] Certain groups of people are at higher risk of subdural hemorrhage: For babies younger than four months; rough shaking could cause brain injury, In older adults; with age brain shrinks, causing fragility, People who take certain medications such as blood thinners, Alcohol abusers, People who play high-impact sports such as football.

• #45 Prognosis of patients with operated chronic subdural hematoma | Scientific Reports

  https://www.nature.com/articles/s41598-022-10992-5

  Chronic subdural hematoma (cSDH), previously considered fairly benign and easy to treat, is now viewed a possible sign of incipient clinical decline. […] Mortality after operated cSDH has generally been associated with high average age and frailty. […] Recently, however, perceptions of the disease have changed, especially as high one-year case-fatality and excess-fatality rates in all treated age groups have been reported. […] cSDH has been associated with higher lingering mortality rates than previously reported. […] Alcohol abuse resulting in the triad of brain atrophy, coagulation dysfunction, and risk for incidental falls, antithrombotic treatment, and older age are the most well-known risk factors for cSDH. […] The results of this study show that the association of even minor comorbidity burden and mortality is evident already in the youngest age group and the association increases with age. […] It can be concluded that patients with diseases causing brain atrophy, such as dementia and chronic alcoholism in particular, are at risk of health deterioration and death after a diagnosis of cSDH.

• #46 Pulsenotes | CSDH

  https://app.pulsenotes.com/surgery/neurosurgery/notes/chronic-subdural-haematoma

  Subdural haematoma is a collection of blood in the subdural space. […] The most common cause of CSDH is trauma. […] The most common cause of CSDH is trauma in nearly 50% of patients. However, most may not even recall the injury as it is often trivial. […] Other causes include: Epilepsy, Haemophilia, Cerebral aneurysms (rarely), Neoplasms. […] A CSDH may develop if the patient has a shunt inserted for cerebrospinal fluid (CSF) drainage. Over-drainage can cause a bleed. […] The mechanism behind CSDH formation is likely multifactorial and goes beyond a tear of a bridging vein. […] CSDH tends to affect elderly patients more than younger patients and the mechanism of injury is usually innocuous.

• #47 Subdural hematoma | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/subdural-hematoma

  A subdural hematoma is a collection of blood that forms in the subdural space, typically resulting from head injuries but sometimes occurring without any apparent trauma. […] CAUSES: Usually major or minor head injuries; some cases arise without apparent head injury. […] Subdural hematomas are caused by either a major head injury (acute subdural hematomas) or by a relatively minor head injury (chronic subdural hematomas). […] Some cases of subdural hematomas occur without apparent head injury, which may be due to the fact that many minor head injuries go unnoticed. […] Blood-thinning drugs such as Coumadin, alcohol abuse, seizures, repeated falls, shunts draining excess cerebrospinal fluid (CSF) from the brain, and very young or very old age increase the risk of developing a subdural hematoma.

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