Materiały źródłowe

• #1

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

  Surgery is recommended for most subdural haematomas. Very small subdural haematomas may be carefully monitored first to see if they heal without having an operation. […] If surgery is recommended, it’ll be carried out by a neurosurgeon (an expert in surgery of the brain and nervous system). […] There are 2 widely used surgical techniques to treat subdural haematomas: craniotomy a section of the skull is temporarily removed so the surgeon can access and remove the haematoma […] burr holes a small hole is drilled into the skull and a tube is inserted through the hole to help drain the haematoma. […] A craniotomy is the main treatment for subdural haematomas that develop soon after a severe head injury (acute subdural haematomas). […] Burr hole surgery is the main treatment for subdural haematomas that develop a few days or weeks after a minor head injury (chronic subdural haematomas).

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

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

  Treatment of subdural hematomas depends on their severity. Treatment can range from watchful waiting to brain surgery. […] In small subdural hematomas with mild symptoms, doctors may recommend no specific treatment other than observation. They often perform repeated head imaging tests to monitor whether the subdural hematoma is improving. […] More dangerous subdural hematomas require surgery to reduce the pressure on the brain. Surgeons can use various techniques to treat subdural hematomas: […] Burr hole trephination. A hole is drilled in the skull over the area of the subdural hematoma, and the blood is suctioned out through the hole. […] Craniotomy. A larger section of the skull is removed to allow better access to the subdural hematoma and reduce pressure. The removed skull is replaced shortly after the procedure.

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

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

  Treatment of subdural hematomas depends on their severity. Treatment can range from watchful waiting to brain surgery. […] In small subdural hematomas with mild symptoms, doctors may recommend no specific treatment other than observation. They often perform repeated head imaging tests to monitor whether the subdural hematoma is improving. […] More dangerous subdural hematomas require surgery to reduce the pressure on the brain. Surgeons can use various techniques to treat subdural hematomas: […] Burr hole trephination. A hole is drilled in the skull over the area of the subdural hematoma, and the blood is suctioned out through the hole. […] Craniotomy. A larger section of the skull is removed to allow better access to the subdural hematoma and reduce pressure. The removed skull is replaced shortly after the procedure.

• #4

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

  Surgery is recommended for most subdural haematomas. Very small subdural haematomas may be carefully monitored first to see if they heal without having an operation. […] If surgery is recommended, it’ll be carried out by a neurosurgeon (an expert in surgery of the brain and nervous system). […] There are 2 widely used surgical techniques to treat subdural haematomas: craniotomy a section of the skull is temporarily removed so the surgeon can access and remove the haematoma […] burr holes a small hole is drilled into the skull and a tube is inserted through the hole to help drain the haematoma. […] A craniotomy is the main treatment for subdural haematomas that develop soon after a severe head injury (acute subdural haematomas). […] Burr hole surgery is the main treatment for subdural haematomas that develop a few days or weeks after a minor head injury (chronic subdural haematomas).

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

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

  Subdural hematomas can be life-threatening and need immediate medical care. […] For large or severe subdural hematomas, you usually need surgery. There are two main types: […] Craniotomy: A neurosurgeon temporarily removes a section of your skull so they can access and remove the hematoma. This is the main treatment for acute subdural hematomas. […] Burr holes: A neurosurgeon drills one or more small holes into your skull. They insert a tube through the hole to help drain the blood. They typically leave a drain in place for several days following surgery to allow the blood to continue draining. This is the main treatment for chronic subdural hematomas. […] Sometimes, hematomas cause few or no symptoms and are small enough that they don’t require surgical treatment. Rest, medications and observation may be all that you need. Your healthcare provider may order regular imaging tests (such as an MRI) to monitor the hematoma and make sure it’s healing.

• #6 Subdural Hematoma Treatment & Management: Approach Considerations, Surgical Decompression, Preoperative Treatments

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

  Although significant acute traumatic SDH requires surgical treatment, temporizing medical maneuvers can be used preoperatively to decrease intracranial pressure. […] Administer anticonvulsants to prevent seizure-induced ischemia and subsequent surges in intracranial pressure. Do not give steroids, as they have been found to be ineffective in patients with head injury. […] The use of sequential CT scanning is important. Although each patient must be treated individually, patients who have small acute SDHs thinner than 5 mm on axial computed tomography (CT) images without sufficient mass effect to cause midline shift or neurological signs have been observed clinically, with acceptable results. […] Hematoma resolution should be documented with serial imaging because an acute subdural hematoma that is treated conservatively can evolve into a chronic hematoma.

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

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

  Craniectomy. A section of the skull is removed for an extended period to allow the injured brain to expand and swell without permanent damage. Craniectomy is not often used to treat subdural hematoma. […] If a person has a bleeding problem or is taking blood thinners, doctors may take measures to improve blood clotting. This can include prescribing medicines or administering blood products, and the reversal of any blood thinners, when possible. […] The short answer is, yes. If you have a very small subdural hematoma, even an acute one, your doctor may recommend letting it heal on its own with careful observation. That’s because any type of brain procedure carries risks, and in some cases, the risk of operating may be greater than allowing your body to mend itself. But you should always let an expert make this call.

• #8 Treating Subdural Hematoma Symptoms | University of Utah Health

  https://healthcare.utah.edu/neurosciences/neurosurgery/subdural-hematoma

  People with an acute subdural hematoma typically do not need treatment because the hematoma will break down in the body over time. However, in some cases, following a head injury, an acute subdural hematoma will need to be treated immediately with surgery to relieve pressure on the brain. […] Treatment options for chronic (non-acute) subdural hematomas include the following: Medication. This may help resolve the subdural hematoma. Brain surgery (craniotomy). This is a surgical procedure that opens the skull to remove the subdural hematoma. Middle meningeal artery (MMA) embolization, which involves guiding a catheter into an artery that is supplying blood to the subdural hematoma and releasing specialized pellets to stop the bleeding. […] Chronic subdural hematomas, in particular, can be complicated and may recur after surgery. Some patients may need a combination of MMA embolization, surgery, and medication. Your neurosurgeon will discuss your options and recommend a personalized treatment plan to ensure the best outcome for your health.

• #9 Subdural hematoma Information | Mount Sinai – New York

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

  A subdural hematoma is an emergency condition. […] Emergency surgery may be needed to reduce pressure within the brain. This may involve drilling a small hole in the skull to drain any blood and relieve pressure on the brain. Large hematomas or solid blood clots may need to be removed through a procedure called a craniotomy, which creates a larger opening in the skull. […] Medicines that may be used depend on the type of subdural hematoma, how severe the symptoms are, and how much brain damage has occurred. Medicines may include: Diuretics (often given intravenously) and corticosteroids to reduce swelling; Anti-seizure medicines to control or prevent seizures.

• #10 Subdural haematoma – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/416

  Subdural haematoma (SDH) has a variable disease course, depending on size of haematoma, age of the patient, presenting neurological signs/symptoms, presence of underlying coagulopathy or neoplasm, and associated injuries. […] One week of prophylactic antiepileptic therapy (e.g., phenytoin, levetiracetam) should be considered in all cases of acute and acute-on-chronic SDH, according to the Brain Trauma Foundation guidelines. […] Aggressive reversal of coagulopathy should be accomplished in most patients with SDH who are taking anticoagulants. […] Surgical therapy is usually indicated for acute or chronic SDHs that are expansile or causing neurological deficit. Observation may be employed for small, stable SDHs that are not causing neurological compromise. […] Control of raised intracranial pressure using head-of-bed elevation, analgesics, intubation with anaesthetics and sedation, hyperosmolar treatment, barbiturates, or decompressive hemicraniectomy may be required. […] Treatment complications include early or delayed re-accumulation of SDH, seizures, vascular injury to cortical veins and arteries or dural sinuses adjacent to the haematoma, strokes, persistent neurological deficit, coma, and death.

• #11 Subdural haematoma – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/416

  Subdural haematoma (SDH) has a variable disease course, depending on size of haematoma, age of the patient, presenting neurological signs/symptoms, presence of underlying coagulopathy or neoplasm, and associated injuries. […] One week of prophylactic antiepileptic therapy (e.g., phenytoin, levetiracetam) should be considered in all cases of acute and acute-on-chronic SDH, according to the Brain Trauma Foundation guidelines. […] Aggressive reversal of coagulopathy should be accomplished in most patients with SDH who are taking anticoagulants. […] Surgical therapy is usually indicated for acute or chronic SDHs that are expansile or causing neurological deficit. Observation may be employed for small, stable SDHs that are not causing neurological compromise. […] Control of raised intracranial pressure using head-of-bed elevation, analgesics, intubation with anaesthetics and sedation, hyperosmolar treatment, barbiturates, or decompressive hemicraniectomy may be required. […] Treatment complications include early or delayed re-accumulation of SDH, seizures, vascular injury to cortical veins and arteries or dural sinuses adjacent to the haematoma, strokes, persistent neurological deficit, coma, and death.

• #12 Subdural hematoma Information | Mount Sinai – New York

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

  A subdural hematoma is an emergency condition. […] Emergency surgery may be needed to reduce pressure within the brain. This may involve drilling a small hole in the skull to drain any blood and relieve pressure on the brain. Large hematomas or solid blood clots may need to be removed through a procedure called a craniotomy, which creates a larger opening in the skull. […] Medicines that may be used depend on the type of subdural hematoma, how severe the symptoms are, and how much brain damage has occurred. Medicines may include: Diuretics (often given intravenously) and corticosteroids to reduce swelling; Anti-seizure medicines to control or prevent seizures.

• #13 Subdural hematoma Information | Mount Sinai – New York

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

  A subdural hematoma is an emergency condition. […] Emergency surgery may be needed to reduce pressure within the brain. This may involve drilling a small hole in the skull to drain any blood and relieve pressure on the brain. Large hematomas or solid blood clots may need to be removed through a procedure called a craniotomy, which creates a larger opening in the skull. […] Medicines that may be used depend on the type of subdural hematoma, how severe the symptoms are, and how much brain damage has occurred. Medicines may include: Diuretics (often given intravenously) and corticosteroids to reduce swelling; Anti-seizure medicines to control or prevent seizures.

• #14 Subdural Hematoma Medication: Osmotic Diuretics

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

  Although significant acute traumatic SDH requires surgical treatment, temporizing medical maneuvers can be preoperatively used to decrease intracranial pressure. […] If the patient exhibits signs of a herniation syndrome, administer mannitol 1 g/kg rapidly by intravenous (IV) push. […] These agents may help reduce intracranial pressure. […] Mannitol may reduce subarachnoid space pressure by creating an osmotic gradient between the cerebrospinal fluid in the arachnoid space and the plasma. It is not for long-term use. Initially assess for adequate renal function in adults by administering a test dose of 200 mg/kg, given IV over 3-5 min; this should produce urine flow of at least 30-50 mL/h of urine over 2-3 hours.

• #15 Subdural hematoma – Wikipedia

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

  Those with chronic subdural hematoma (CSDH) with few or no symptoms or have high risk of complication during surgery may be treated conservatively with medications such as atorvastatin, dexamethasone, and mannitol, although supporting conservative treatment is still weak. HMG-CoA reductase inhibitor such as Atorvastatin can reduce the hematoma volume and improve neurological function in eight weeks. HMG-CoA reductase inhibitor may also reduce risk of recurrences in CSDH. Dexamethasone, when used together with surgical drainage, may reduce the recurrence rate of subdural hematoma. Even with surgical evacuation of chronic subdural hematoma, the recurrence rate is high, ranging from 7 to 20%.

• #16 Expert consensus on drug treatment of chronic subdural hematoma | Chinese Neurosurgical Journal | Full Text

  https://cnjournal.biomedcentral.com/articles/10.1186/s41016-021-00263-z

  The aim of drug treatment is to improve symptoms and signs of patients and promote hematoma absorption. Drug treatment can be divided into symptomatic treatment and treatment promoting hematoma absorption. […] The recommended drugs for CSDH treatment in this consensus are atorvastatin and dexamethasone. […] Recommendation 2: For patients with CSDH who meet the indications of drug treatment, low-dose and long-term use of atorvastatin (20 mg/day) is suggested for continuous treatment for at least 8 weeks, until neurological symptoms and signs disappear and hematoma absorption is satisfactory; the drug is then discontinued (high-quality evidence, strong recommendation). […] Recommendation 3: High-dose (1216 mg/day) or long-term (more than 3 months) routine use of dexamethasone is not recommended due to its large side effects (high-quality evidence, strong recommendation); low-dose and short-term use of dexamethasone can improve the therapeutic effect of atorvastatin on CSDH.

• #17 Subdural hematoma – Wikipedia

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

  Those with chronic subdural hematoma (CSDH) with few or no symptoms or have high risk of complication during surgery may be treated conservatively with medications such as atorvastatin, dexamethasone, and mannitol, although supporting conservative treatment is still weak. HMG-CoA reductase inhibitor such as Atorvastatin can reduce the hematoma volume and improve neurological function in eight weeks. HMG-CoA reductase inhibitor may also reduce risk of recurrences in CSDH. Dexamethasone, when used together with surgical drainage, may reduce the recurrence rate of subdural hematoma. Even with surgical evacuation of chronic subdural hematoma, the recurrence rate is high, ranging from 7 to 20%.

• #18 Expert consensus on drug treatment of chronic subdural hematoma | Chinese Neurosurgical Journal | Full Text

  https://cnjournal.biomedcentral.com/articles/10.1186/s41016-021-00263-z

  The aim of drug treatment is to improve symptoms and signs of patients and promote hematoma absorption. Drug treatment can be divided into symptomatic treatment and treatment promoting hematoma absorption. […] The recommended drugs for CSDH treatment in this consensus are atorvastatin and dexamethasone. […] Recommendation 2: For patients with CSDH who meet the indications of drug treatment, low-dose and long-term use of atorvastatin (20 mg/day) is suggested for continuous treatment for at least 8 weeks, until neurological symptoms and signs disappear and hematoma absorption is satisfactory; the drug is then discontinued (high-quality evidence, strong recommendation). […] Recommendation 3: High-dose (1216 mg/day) or long-term (more than 3 months) routine use of dexamethasone is not recommended due to its large side effects (high-quality evidence, strong recommendation); low-dose and short-term use of dexamethasone can improve the therapeutic effect of atorvastatin on CSDH.

• #19 Treatment of chronic subdural hematoma with atorvastatin combined with low-dose dexamethasone: phase II randomized proof-of-concept clinical trial in: Journal of Neurosurgery Volume 134 Issue 1 (2020) Journals

  https://thejns.org/view/journals/j-neurosurg/134/1/article-p235.xml

  The authors sought to test the hypothesis that adding dexamethasone (DXM) to atorvastatin (ATO) potentiates the effects of ATO on chronic subdural hematoma (CSDH). […] Patients were randomized to receive a 5-week regimen of ATO 20 mg daily or ATO 20 mg daily plus a DXM regimen (ATO+DXM). The primary endpoint was hematoma reduction assessed by neuroimaging at baseline and at 5 weeks of follow-up. […] The patients who were treated with ATO+DXM had more obvious hematoma reduction at the 5th week (between-groups difference 18.37 ml; 95% CI 8.1728.57; p = 0.0005). […] Complete recovery of neurological function (MGS-GCS grade 0) at 5 weeks was achieved in 83.33% and 32.14% of patients in the ATO+DXM and ATO groups, respectively. […] ATO+DXM was more effective than ATO alone in reducing hematoma and improving neurological function in patients with CSDH. These results require further confirmation in a randomized placebo-controlled trial.

• #20

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

  Subdural haematomas usually need to be treated with surgery as soon as possible. […] The 2 most widely used surgical techniques for subdural haematomas are: […] craniotomy a section of the skull is temporarily removed so the surgeon can access and remove the haematoma […] burr holes a small hole is drilled into the skull and a tube is inserted through the hole to help drain the haematoma. […] In a few cases, very small subdural haematomas may be carefully monitored first to see if they heal without having an operation.

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

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

  Subdural hematomas can be life-threatening and need immediate medical care. […] For large or severe subdural hematomas, you usually need surgery. There are two main types: […] Craniotomy: A neurosurgeon temporarily removes a section of your skull so they can access and remove the hematoma. This is the main treatment for acute subdural hematomas. […] Burr holes: A neurosurgeon drills one or more small holes into your skull. They insert a tube through the hole to help drain the blood. They typically leave a drain in place for several days following surgery to allow the blood to continue draining. This is the main treatment for chronic subdural hematomas. […] Sometimes, hematomas cause few or no symptoms and are small enough that they don’t require surgical treatment. Rest, medications and observation may be all that you need. Your healthcare provider may order regular imaging tests (such as an MRI) to monitor the hematoma and make sure it’s healing.

• #22

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

  Surgery is recommended for most subdural haematomas. Very small subdural haematomas may be carefully monitored first to see if they heal without having an operation. […] If surgery is recommended, it’ll be carried out by a neurosurgeon (an expert in surgery of the brain and nervous system). […] There are 2 widely used surgical techniques to treat subdural haematomas: craniotomy a section of the skull is temporarily removed so the surgeon can access and remove the haematoma […] burr holes a small hole is drilled into the skull and a tube is inserted through the hole to help drain the haematoma. […] A craniotomy is the main treatment for subdural haematomas that develop soon after a severe head injury (acute subdural haematomas). […] Burr hole surgery is the main treatment for subdural haematomas that develop a few days or weeks after a minor head injury (chronic subdural haematomas).

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

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

  Subdural hematomas can be life-threatening and need immediate medical care. […] For large or severe subdural hematomas, you usually need surgery. There are two main types: […] Craniotomy: A neurosurgeon temporarily removes a section of your skull so they can access and remove the hematoma. This is the main treatment for acute subdural hematomas. […] Burr holes: A neurosurgeon drills one or more small holes into your skull. They insert a tube through the hole to help drain the blood. They typically leave a drain in place for several days following surgery to allow the blood to continue draining. This is the main treatment for chronic subdural hematomas. […] Sometimes, hematomas cause few or no symptoms and are small enough that they don’t require surgical treatment. Rest, medications and observation may be all that you need. Your healthcare provider may order regular imaging tests (such as an MRI) to monitor the hematoma and make sure it’s healing.

• #24 Subdural Hematoma Treatment & Management: Approach Considerations, Surgical Decompression, Preoperative Treatments

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

  Consult a neurosurgeon as soon as the diagnosis is suspected and initiate transfer if another facility is required for diagnosis or management. […] The mechanism, exact pathophysiology, and optimal treatment for chronic SDH has still not been definitively determined. Further work in delineating why membranes form and how to prevent or reverse their formation may lead to improvements in treatment strategies. […] Although hematoma resolution has been reported, it cannot be reliably predicted, and no medical therapy has been shown to be effective in expediting the resolution of acute or chronic SDH. […] Surgery for emergent decompression has been advocated if the acute SDH is associated with a midline shift greater than or equal to 5 mm. Surgery also has been recommended for acute SDHs exceeding 1 cm in thickness.

• #25 Subdural Hematoma Treatment & Management: Approach Considerations, Surgical Decompression, Preoperative Treatments

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

  These guidelines also call for emergent decompression in a comatose patient with an acute SDH less than 1 cm in thickness causing a midline shift of less than 5 mm if any of the following criteria are met: The GCS score decreases by 2 or more points between the time of injury and hospital evaluation, The patient presents with fixed and dilated pupils, The intracranial pressure (ICP) exceeds 20 mm Hg. […] In a series of patients with acute traumatic SDH initially treated conservatively, investigators found that if patients presented with a GCS score of 15 or lower and a midline shift greater than 5 mm, their condition usually would deteriorate and they would require surgery. […] A meta-analysis comparing the efficacy of various methods of chronic SDH evacuation supported twist drill craniostomy drainage at the bedside for patients who are high-risk surgical candidates with nonseptated chronic subdural hematomas.

• #26 Subdural Hematoma Treatment & Management: Approach Considerations, Surgical Decompression, Preoperative Treatments

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

  These guidelines also call for emergent decompression in a comatose patient with an acute SDH less than 1 cm in thickness causing a midline shift of less than 5 mm if any of the following criteria are met: The GCS score decreases by 2 or more points between the time of injury and hospital evaluation, The patient presents with fixed and dilated pupils, The intracranial pressure (ICP) exceeds 20 mm Hg. […] In a series of patients with acute traumatic SDH initially treated conservatively, investigators found that if patients presented with a GCS score of 15 or lower and a midline shift greater than 5 mm, their condition usually would deteriorate and they would require surgery. […] A meta-analysis comparing the efficacy of various methods of chronic SDH evacuation supported twist drill craniostomy drainage at the bedside for patients who are high-risk surgical candidates with nonseptated chronic subdural hematomas.

• #27 Subdural Hematoma Treatment & Management: Approach Considerations, Surgical Decompression, Preoperative Treatments

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

  These guidelines also call for emergent decompression in a comatose patient with an acute SDH less than 1 cm in thickness causing a midline shift of less than 5 mm if any of the following criteria are met: The GCS score decreases by 2 or more points between the time of injury and hospital evaluation, The patient presents with fixed and dilated pupils, The intracranial pressure (ICP) exceeds 20 mm Hg. […] In a series of patients with acute traumatic SDH initially treated conservatively, investigators found that if patients presented with a GCS score of 15 or lower and a midline shift greater than 5 mm, their condition usually would deteriorate and they would require surgery. […] A meta-analysis comparing the efficacy of various methods of chronic SDH evacuation supported twist drill craniostomy drainage at the bedside for patients who are high-risk surgical candidates with nonseptated chronic subdural hematomas.

• #28 Subdural Hematoma Treatment & Management: Approach Considerations, Surgical Decompression, Preoperative Treatments

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

  These guidelines also call for emergent decompression in a comatose patient with an acute SDH less than 1 cm in thickness causing a midline shift of less than 5 mm if any of the following criteria are met: The GCS score decreases by 2 or more points between the time of injury and hospital evaluation, The patient presents with fixed and dilated pupils, The intracranial pressure (ICP) exceeds 20 mm Hg. […] In a series of patients with acute traumatic SDH initially treated conservatively, investigators found that if patients presented with a GCS score of 15 or lower and a midline shift greater than 5 mm, their condition usually would deteriorate and they would require surgery. […] A meta-analysis comparing the efficacy of various methods of chronic SDH evacuation supported twist drill craniostomy drainage at the bedside for patients who are high-risk surgical candidates with nonseptated chronic subdural hematomas.

• #29

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

  Surgery is recommended for most subdural haematomas. Very small subdural haematomas may be carefully monitored first to see if they heal without having an operation. […] If surgery is recommended, it’ll be carried out by a neurosurgeon (an expert in surgery of the brain and nervous system). […] There are 2 widely used surgical techniques to treat subdural haematomas: craniotomy a section of the skull is temporarily removed so the surgeon can access and remove the haematoma […] burr holes a small hole is drilled into the skull and a tube is inserted through the hole to help drain the haematoma. […] A craniotomy is the main treatment for subdural haematomas that develop soon after a severe head injury (acute subdural haematomas). […] Burr hole surgery is the main treatment for subdural haematomas that develop a few days or weeks after a minor head injury (chronic subdural haematomas).

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

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

  Subdural hematomas can be life-threatening and need immediate medical care. […] For large or severe subdural hematomas, you usually need surgery. There are two main types: […] Craniotomy: A neurosurgeon temporarily removes a section of your skull so they can access and remove the hematoma. This is the main treatment for acute subdural hematomas. […] Burr holes: A neurosurgeon drills one or more small holes into your skull. They insert a tube through the hole to help drain the blood. They typically leave a drain in place for several days following surgery to allow the blood to continue draining. This is the main treatment for chronic subdural hematomas. […] Sometimes, hematomas cause few or no symptoms and are small enough that they don’t require surgical treatment. Rest, medications and observation may be all that you need. Your healthcare provider may order regular imaging tests (such as an MRI) to monitor the hematoma and make sure it’s healing.

• #31

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

  Burr hole surgery is often carried out under general anaesthetic, but is sometimes done under local anaesthetic. […] If surgery goes well and you do not have any complications, you may be well enough to leave hospital after a few days. […] If you have persistent problems after surgery, such as memory problems or weakness in your limbs, you may need further treatment to help you gradually return to your normal activities.

• #32 How to Treat Chronic Subdural Hematoma? Past and Now

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6411568/

  In general, the decision to operate is based on the presence of symptoms and clinical or imaging signs of cerebral compression. […] Shared decision making can be an ideal approach to clinician-patient decision making, improve the quality of medical decisions, and reduce costs. […] The most commonly used surgical methods are TD craniostomy, BH trephination, and craniotomy. […] A systematic review and meta-analysis with 34829 patients revealed no significant difference in the rate of cure, recurrence, morbidity, or mortality between TD and BH. […] Although there are diverse practices in detail, vast majority of CSDH can be treated either by TD or BH. […] For the recurrent CSDHs, if the risk of recurrence is low, still repeated trephination is simple and effective. If the risk of recurrence is high, additional management such as EMMA may reduce the chance of recurrence. […] For the refractory CSDHs, it is necessary to obliterate the subdural space by lumbar or ventricular injection, fibrin glue injection or reducing the dura.

• #33 How to Treat Chronic Subdural Hematoma? Past and Now

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6411568/

  In general, the decision to operate is based on the presence of symptoms and clinical or imaging signs of cerebral compression. […] Shared decision making can be an ideal approach to clinician-patient decision making, improve the quality of medical decisions, and reduce costs. […] The most commonly used surgical methods are TD craniostomy, BH trephination, and craniotomy. […] A systematic review and meta-analysis with 34829 patients revealed no significant difference in the rate of cure, recurrence, morbidity, or mortality between TD and BH. […] Although there are diverse practices in detail, vast majority of CSDH can be treated either by TD or BH. […] For the recurrent CSDHs, if the risk of recurrence is low, still repeated trephination is simple and effective. If the risk of recurrence is high, additional management such as EMMA may reduce the chance of recurrence. […] For the refractory CSDHs, it is necessary to obliterate the subdural space by lumbar or ventricular injection, fibrin glue injection or reducing the dura.

• #34

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4556906/

  2. Minimal craniotomy (trephination) – is one of the most often used surgical techniques in cases of current chronic subdural haematomas. […] 3. Single twist drill trephination presents the great advantage that it can be performed in the hospital bed while using local anesthesia or in the surgery room under local or general anesthesia. […] The relapse in cases of chronic subdural haematomas means the symptomatic relapse of the subdural haematoma in the area which was already operated on. […] According to a very thorough and on a long period of time study done in India, on a period of 30 years, which consisted of 2300 cases, the best technique was considered temporal craniotomy with the dura mater left open and the subdural area communicating with the subtemporal area. […] In spite of these published results, the treatment of chronic subdural haematomas remains a controversy!

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

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

  Craniectomy. A section of the skull is removed for an extended period to allow the injured brain to expand and swell without permanent damage. Craniectomy is not often used to treat subdural hematoma. […] If a person has a bleeding problem or is taking blood thinners, doctors may take measures to improve blood clotting. This can include prescribing medicines or administering blood products, and the reversal of any blood thinners, when possible. […] The short answer is, yes. If you have a very small subdural hematoma, even an acute one, your doctor may recommend letting it heal on its own with careful observation. That’s because any type of brain procedure carries risks, and in some cases, the risk of operating may be greater than allowing your body to mend itself. But you should always let an expert make this call.

• #36 Treating Subdural Hematoma Symptoms | University of Utah Health

  https://healthcare.utah.edu/neurosciences/neurosurgery/subdural-hematoma

  People with an acute subdural hematoma typically do not need treatment because the hematoma will break down in the body over time. However, in some cases, following a head injury, an acute subdural hematoma will need to be treated immediately with surgery to relieve pressure on the brain. […] Treatment options for chronic (non-acute) subdural hematomas include the following: Medication. This may help resolve the subdural hematoma. Brain surgery (craniotomy). This is a surgical procedure that opens the skull to remove the subdural hematoma. Middle meningeal artery (MMA) embolization, which involves guiding a catheter into an artery that is supplying blood to the subdural hematoma and releasing specialized pellets to stop the bleeding. […] Chronic subdural hematomas, in particular, can be complicated and may recur after surgery. Some patients may need a combination of MMA embolization, surgery, and medication. Your neurosurgeon will discuss your options and recommend a personalized treatment plan to ensure the best outcome for your health.

• #37 Treating Subdural Hematoma Symptoms | University of Utah Health

  https://healthcare.utah.edu/neurosciences/neurosurgery/subdural-hematoma

  We may need to treat some chronic subdural hematomas with brain surgery to drain the blood that has collected between the brain and the dura (outermost covering of the brain). […] MMA embolization is a minimally invasive, non-surgical procedure that takes place in our state-of-the-art Neurointerventional Radiology Suite. […] As a non-surgical alternative, undergoing MMA embolization includes shorter hospital stays and a faster recovery. This is commonly used as a stand-alone treatment for a patient with a chronic subdural hematoma. In some cases, your neurosurgeon may recommend MMA embolization as a follow-up therapy if initial brain surgery for the chronic subdural hematoma was not successful. This has been shown to decrease the risk of a recurring hematoma and decrease the chances of needing another operation to re-drain it.

• #38 Treating Subdural Hematoma Symptoms | University of Utah Health

  https://healthcare.utah.edu/neurosciences/neurosurgery/subdural-hematoma

  We may need to treat some chronic subdural hematomas with brain surgery to drain the blood that has collected between the brain and the dura (outermost covering of the brain). […] MMA embolization is a minimally invasive, non-surgical procedure that takes place in our state-of-the-art Neurointerventional Radiology Suite. […] As a non-surgical alternative, undergoing MMA embolization includes shorter hospital stays and a faster recovery. This is commonly used as a stand-alone treatment for a patient with a chronic subdural hematoma. In some cases, your neurosurgeon may recommend MMA embolization as a follow-up therapy if initial brain surgery for the chronic subdural hematoma was not successful. This has been shown to decrease the risk of a recurring hematoma and decrease the chances of needing another operation to re-drain it.

• #39 Subdural Hematoma Symptoms, Treatment & Surgery

  https://www.neurosurgeonsofnewjersey.com/blog/subdural-hematoma-treatment/

  A rapidly growing hematoma in the subdural space is a collection of very acute and fresh blood and it will typically require surgical treatment. […] Treatment for a subdural hematoma include a range of options that go from watchful waiting to requiring brain surgery with one or two burr holes. […] Burr holes are quarter sized small holes above your ear done in an operating room by a neurosurgeon. The small hole allows for the blood to get drained out and relieve the high pressure it has caused on the brain. […] To decrease the chance of that recurrence, your neurosurgeon may offer you an angiogram. […] During an angiogram (angiography), a catheter is inserted through an artery in the groin or wrist, and threaded into the arteries of the neck and brain. […] This procedure allows direct access to the main blood supply of the dura, the middle meningeal artery (MMA), and is capable of occluding those blood vessels, and thereby allowing the collection to be resorbed without recurrence. […] Treatment can vary, and you can get more advice on this condition from one of our specialists.

• #40 New Treatment Combination for Subdural Hematoma Reduces Risk of Recurrence | Newsroom | Weill Cornell Medicine

  https://news.weill.cornell.edu/news/2024/11/new-treatment-combination-for-subdural-hematoma-reduces-risk-of-recurrence

  The hematoma recruits arterial blood vessels that keep it alive. […] The procedure involves threading a small catheter into the middle meningeal artery that runs through the membranes covering the brain. […] The catheter delivers an embolic or clotting agent to block blood vessels feeding the hematoma. […] By reducing the chance of the subdural hematoma from coming back, the need for hospital re-admission and another operation can be avoided, Dr. Knopman said. […] Hematoma recurrence or progression leading to another surgery within 90 days of the initial surgery occurred in approximately 4% of the treatment group compared to 11.3% of the control group. […] Dr. Knopman and his colleagues are now determining what role upfront MMA embolization could have in treating patients with chronic subdural hematomas that are not large enough for surgery. […] If we embolize these patients early, we may decrease the number who need to be taken to surgery later, he said.

• #41 For chronic subdural hematomas, blocking the artery supplying the brain covering reduced re-operations threefold – UBNow: News and views for UB faculty and staff – University at Buffalo

  https://www.buffalo.edu/ubnow/stories/2024/11/davies-nejm-subdural-hematoma.html

  In the study, the 197 patients who received the intervention underwent a nonsurgical procedure called middle meningeal artery embolization aimed at reducing the blood supply to inflamed vascular membranes in the dura. Blocking or essentially gluing shut the artery in the brain that is bleeding resulted in a far lower rate of hematoma recurrence. […] To do it, investigators used Onyx, made by Medtronic, a liquid embolic agent that is used to occlude blood vessels. The liquid is administered non-surgically through the endovascular system via catheterization in the patients wrist or groin, another important advantage. […] Davies says the next phase in the trial involves patients who do not require surgery initially, assessing whether embolization of the middle meningeal artery can avoid the need for surgery in the first place. […] This significant advancement in treating chronic subdural hematoma, particularly for our elderly population, underscores our commitment to improving patient outcomes through innovative research and clinical excellence.

• #42 New Treatment Combination for Subdural Hematoma Reduces Risk of Recurrence | Newsroom | Weill Cornell Medicine

  https://news.weill.cornell.edu/news/2024/11/new-treatment-combination-for-subdural-hematoma-reduces-risk-of-recurrence

  A novel combination of surgery and embolization used to treat subdural hematomas, bleeding between the brain and its protective membrane due to trauma, reduces the risk of follow-up surgeries, according to researchers at Weill Cornell Medicine and University at Buffalo. […] The finding is based on EMBOLISE, a multi-center, randomized, clinical study that compared chronic subdural hematoma recurrence rates in patients treated with surgery and middle meningeal artery (MMA) embolization versus current standard of care with surgery alone. […] This trial provides evidence that adding MMA embolization should be a new standard of care for one of the most common neurosurgical conditions we see, said co-lead author and pioneer of MMA embolization, Dr. Jared Knopman. […] However, after a hematoma has been surgically drained, it recurs about 15% of the time, requiring another surgery and hospitalization.

• #43 New Treatment Combination for Subdural Hematoma Reduces Risk of Recurrence | Newsroom | Weill Cornell Medicine

  https://news.weill.cornell.edu/news/2024/11/new-treatment-combination-for-subdural-hematoma-reduces-risk-of-recurrence

  The hematoma recruits arterial blood vessels that keep it alive. […] The procedure involves threading a small catheter into the middle meningeal artery that runs through the membranes covering the brain. […] The catheter delivers an embolic or clotting agent to block blood vessels feeding the hematoma. […] By reducing the chance of the subdural hematoma from coming back, the need for hospital re-admission and another operation can be avoided, Dr. Knopman said. […] Hematoma recurrence or progression leading to another surgery within 90 days of the initial surgery occurred in approximately 4% of the treatment group compared to 11.3% of the control group. […] Dr. Knopman and his colleagues are now determining what role upfront MMA embolization could have in treating patients with chronic subdural hematomas that are not large enough for surgery. […] If we embolize these patients early, we may decrease the number who need to be taken to surgery later, he said.

• #44 For chronic subdural hematomas, blocking the artery supplying the brain covering reduced re-operations threefold – UBNow: News and views for UB faculty and staff – University at Buffalo

  https://www.buffalo.edu/ubnow/stories/2024/11/davies-nejm-subdural-hematoma.html

  A dramatic, threefold reduction in repeat operations in patients surgically treated for chronic subdural hematoma was achieved when the artery supplying the brain covering was blocked, according to results of a national clinical trial led by neurosurgeons at UB and Weill Cornell Medicine that was published Nov. 21 in the New England Journal of Medicine. […] We are changing the way that we are treating this very common disease, says Jason M. Davies, corresponding author and associate professor of neurosurgery in the Jacobs School of Medicine and Biomedical Sciences at UB. We are changing subdural hematoma from being a disease that commonly requires multiple surgeries to a disease that can be better treated with a simple, minimally invasive procedure that produces better outcomes. […] Our study found a threefold reduction in the rates of recurrence. So, for every hundred patients who undergo treatment for this disease, weve reduced the number of recurrences from about 11 to about four.

• #45 Treating Subdural Hematoma Symptoms | University of Utah Health

  https://healthcare.utah.edu/neurosciences/neurosurgery/subdural-hematoma

  We may need to treat some chronic subdural hematomas with brain surgery to drain the blood that has collected between the brain and the dura (outermost covering of the brain). […] MMA embolization is a minimally invasive, non-surgical procedure that takes place in our state-of-the-art Neurointerventional Radiology Suite. […] As a non-surgical alternative, undergoing MMA embolization includes shorter hospital stays and a faster recovery. This is commonly used as a stand-alone treatment for a patient with a chronic subdural hematoma. In some cases, your neurosurgeon may recommend MMA embolization as a follow-up therapy if initial brain surgery for the chronic subdural hematoma was not successful. This has been shown to decrease the risk of a recurring hematoma and decrease the chances of needing another operation to re-drain it.

• #46 New Treatment Combination for Subdural Hematoma Reduces Risk of Recurrence | Newsroom | Weill Cornell Medicine

  https://news.weill.cornell.edu/news/2024/11/new-treatment-combination-for-subdural-hematoma-reduces-risk-of-recurrence

  The hematoma recruits arterial blood vessels that keep it alive. […] The procedure involves threading a small catheter into the middle meningeal artery that runs through the membranes covering the brain. […] The catheter delivers an embolic or clotting agent to block blood vessels feeding the hematoma. […] By reducing the chance of the subdural hematoma from coming back, the need for hospital re-admission and another operation can be avoided, Dr. Knopman said. […] Hematoma recurrence or progression leading to another surgery within 90 days of the initial surgery occurred in approximately 4% of the treatment group compared to 11.3% of the control group. […] Dr. Knopman and his colleagues are now determining what role upfront MMA embolization could have in treating patients with chronic subdural hematomas that are not large enough for surgery. […] If we embolize these patients early, we may decrease the number who need to be taken to surgery later, he said.

• #47 For chronic subdural hematomas, blocking the artery supplying the brain covering reduced re-operations threefold – UBNow: News and views for UB faculty and staff – University at Buffalo

  https://www.buffalo.edu/ubnow/stories/2024/11/davies-nejm-subdural-hematoma.html

  A dramatic, threefold reduction in repeat operations in patients surgically treated for chronic subdural hematoma was achieved when the artery supplying the brain covering was blocked, according to results of a national clinical trial led by neurosurgeons at UB and Weill Cornell Medicine that was published Nov. 21 in the New England Journal of Medicine. […] We are changing the way that we are treating this very common disease, says Jason M. Davies, corresponding author and associate professor of neurosurgery in the Jacobs School of Medicine and Biomedical Sciences at UB. We are changing subdural hematoma from being a disease that commonly requires multiple surgeries to a disease that can be better treated with a simple, minimally invasive procedure that produces better outcomes. […] Our study found a threefold reduction in the rates of recurrence. So, for every hundred patients who undergo treatment for this disease, weve reduced the number of recurrences from about 11 to about four.

• #48

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4556906/

  Many neurosurgeons recommend a minimal craniotomy followed by an irrigation of the subdural area with sodium chloride solution and the use of a vacuum drainage system. […] Other neurosurgeons recommend the endoscopic treatment of chronic subdural haematomas, especially the septated ones. […] Another special category in the treatment of chronic subdural haematomas is the patients with anticoagulant treatment. […] A recent study has shown that the anticoagulant treatment raises to 42,5 times the risk of developing a chronic subdural haematoma. […] The initial treatment of coagulopathy is necessary even in patients with severe cardiac pathology with a specific indication of anticoagulants, as for example the patients with valvular prostheses. […] The ones undergoing antiplatelets therapy represent another category of patients at risk.

• #49 Transforming Subdural Hematoma Treatment in the Elderly: Insights from an Endoscopic Case Series | In Vivo

  https://iv.iiarjournals.org/content/38/6/3011

  Background/Aim: Subdural hematoma (SDH), a critical brain condition, significantly affects the elderly, making traditional surgeries risky due to their length and potential for blood loss. Endoscope-assisted evacuation offers a safer, less invasive alternative by reducing operation time and minimizing damage, providing an effective solution for older patients. […] Conclusion: Endoscope-assisted evacuation is a safe, efficient treatment for elderly patients with various stages of SDH, offering a less invasive option with potential for better outcomes. It supports the trend towards minimally invasive neurosurgery, with further research needed to optimize patient selection and understand long-term benefits. […] In summary, our research highlights the safety and time-efficiency of endoscope-assisted evacuation for ASDHs, SASDHs, and ACSDHs in selected patients, presenting it as a less invasive and promising alternative to traditional surgical methods. This approach not only offers potential for improved patient outcomes but also encourages a shift towards minimally invasive techniques in managing suitable cases of ASDHs, SASDHs, and ACSDHs. Future studies should further explore patient selection criteria and long-term impacts to enhance care for this vulnerable population.

• #50 Subdural Hematoma Treatment & Management: Approach Considerations, Surgical Decompression, Preoperative Treatments

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

  As with any trauma patient, resuscitation begins with the ABCs (airway, breathing, circulation). All patients with a Glasgow Coma Scale (GCS) score of less than 8 should be intubated for airway protection. […] Despite prompt surgical evacuation of hematomas, patients with acute SDH often have a poor prognosis because of associated underlying brain injury. Patients often require intensive care postoperatively for ventilator-dependent respiration, strict blood pressure control, and management of intracranial hypertension. […] When deciding whether to operate, consider the patient’s prognosis. The ideal is to maximize the likelihood of appropriate resource allocation and, more importantly, allow for appropriate family counseling; keep in mind that no method of assessing the prognosis is 100% accurate.

• #51 Subdural Hematoma Treatment & Management: Approach Considerations, Surgical Decompression, Preoperative Treatments

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

  As with any trauma patient, resuscitation begins with the ABCs (airway, breathing, circulation). All patients with a Glasgow Coma Scale (GCS) score of less than 8 should be intubated for airway protection. […] Despite prompt surgical evacuation of hematomas, patients with acute SDH often have a poor prognosis because of associated underlying brain injury. Patients often require intensive care postoperatively for ventilator-dependent respiration, strict blood pressure control, and management of intracranial hypertension. […] When deciding whether to operate, consider the patient’s prognosis. The ideal is to maximize the likelihood of appropriate resource allocation and, more importantly, allow for appropriate family counseling; keep in mind that no method of assessing the prognosis is 100% accurate.

• #52 Subdural Hematoma Treatment & Management: Approach Considerations, Surgical Decompression, Preoperative Treatments

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

  As with any trauma patient, resuscitation begins with the ABCs (airway, breathing, circulation). All patients with a Glasgow Coma Scale (GCS) score of less than 8 should be intubated for airway protection. […] Despite prompt surgical evacuation of hematomas, patients with acute SDH often have a poor prognosis because of associated underlying brain injury. Patients often require intensive care postoperatively for ventilator-dependent respiration, strict blood pressure control, and management of intracranial hypertension. […] When deciding whether to operate, consider the patient’s prognosis. The ideal is to maximize the likelihood of appropriate resource allocation and, more importantly, allow for appropriate family counseling; keep in mind that no method of assessing the prognosis is 100% accurate.

• #53 Subdural Hematoma Treatment & Management: Approach Considerations, Surgical Decompression, Preoperative Treatments

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

  As with any trauma patient, resuscitation begins with the ABCs (airway, breathing, circulation). All patients with a Glasgow Coma Scale (GCS) score of less than 8 should be intubated for airway protection. […] Despite prompt surgical evacuation of hematomas, patients with acute SDH often have a poor prognosis because of associated underlying brain injury. Patients often require intensive care postoperatively for ventilator-dependent respiration, strict blood pressure control, and management of intracranial hypertension. […] When deciding whether to operate, consider the patient’s prognosis. The ideal is to maximize the likelihood of appropriate resource allocation and, more importantly, allow for appropriate family counseling; keep in mind that no method of assessing the prognosis is 100% accurate.

• #54 Subdural Hematoma Treatment & Management: Approach Considerations, Surgical Decompression, Preoperative Treatments

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

  Although significant acute traumatic SDH requires surgical treatment, temporizing medical maneuvers can be used preoperatively to decrease intracranial pressure. […] Administer anticonvulsants to prevent seizure-induced ischemia and subsequent surges in intracranial pressure. Do not give steroids, as they have been found to be ineffective in patients with head injury. […] The use of sequential CT scanning is important. Although each patient must be treated individually, patients who have small acute SDHs thinner than 5 mm on axial computed tomography (CT) images without sufficient mass effect to cause midline shift or neurological signs have been observed clinically, with acceptable results. […] Hematoma resolution should be documented with serial imaging because an acute subdural hematoma that is treated conservatively can evolve into a chronic hematoma.

• #55

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

  Burr hole surgery is often carried out under general anaesthetic, but is sometimes done under local anaesthetic. […] If surgery goes well and you do not have any complications, you may be well enough to leave hospital after a few days. […] If you have persistent problems after surgery, such as memory problems or weakness in your limbs, you may need further treatment to help you gradually return to your normal activities.

• #56

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

  Burr hole surgery is often carried out under general anaesthetic, but is sometimes done under local anaesthetic. […] If surgery goes well and you do not have any complications, you may be well enough to leave hospital after a few days. […] If you have persistent problems after surgery, such as memory problems or weakness in your limbs, you may need further treatment to help you gradually return to your normal activities.

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

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

  The length of time it takes to recover from a subdural hematoma varies from person to person. Your healthcare provider can tell you what to expect based on your unique situation. Some people feel better a few weeks after treatment, while others may never make a full recovery. […] If you have persistent symptoms after surgery like memory problems or weakness, you may need further treatment to help you gradually return to your normal activities.

• #58 Subdural Hematoma Symptoms & Treatment | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/subdural-hematoma

  Recovery and rehabilitation for subdural hematomas is different for each individual. Depending on the severity and damage from the subdural hematoma, recovery can take weeks to months, and some people may even have life-long complications from it. […] There are several therapy options for rehabilitation, which include: […] Physiotherapy. Helps restore and correct issues with coordination, movement, and muscle weakness. […] Occupational therapy. Focuses on helping patients perform normal day to day tasks and activities again. […] Speech or language therapy. Focuses on helping patients to regain or improve speech or language issues. […] Psychological support or therapy. Seeks to resolve issues related to mood, emotional stability, behavioral issues, adjustment issues, or problems with focus and concentration.

• #59 Subdural Hematoma Symptoms & Treatment | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/subdural-hematoma

  Recovery and rehabilitation for subdural hematomas is different for each individual. Depending on the severity and damage from the subdural hematoma, recovery can take weeks to months, and some people may even have life-long complications from it. […] There are several therapy options for rehabilitation, which include: […] Physiotherapy. Helps restore and correct issues with coordination, movement, and muscle weakness. […] Occupational therapy. Focuses on helping patients perform normal day to day tasks and activities again. […] Speech or language therapy. Focuses on helping patients to regain or improve speech or language issues. […] Psychological support or therapy. Seeks to resolve issues related to mood, emotional stability, behavioral issues, adjustment issues, or problems with focus and concentration.

• #60 Subdural Hematoma Symptoms & Treatment | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/subdural-hematoma

  Recovery and rehabilitation for subdural hematomas is different for each individual. Depending on the severity and damage from the subdural hematoma, recovery can take weeks to months, and some people may even have life-long complications from it. […] There are several therapy options for rehabilitation, which include: […] Physiotherapy. Helps restore and correct issues with coordination, movement, and muscle weakness. […] Occupational therapy. Focuses on helping patients perform normal day to day tasks and activities again. […] Speech or language therapy. Focuses on helping patients to regain or improve speech or language issues. […] Psychological support or therapy. Seeks to resolve issues related to mood, emotional stability, behavioral issues, adjustment issues, or problems with focus and concentration.

• #61 Subdural Hematoma Symptoms & Treatment | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/subdural-hematoma

  Recovery and rehabilitation for subdural hematomas is different for each individual. Depending on the severity and damage from the subdural hematoma, recovery can take weeks to months, and some people may even have life-long complications from it. […] There are several therapy options for rehabilitation, which include: […] Physiotherapy. Helps restore and correct issues with coordination, movement, and muscle weakness. […] Occupational therapy. Focuses on helping patients perform normal day to day tasks and activities again. […] Speech or language therapy. Focuses on helping patients to regain or improve speech or language issues. […] Psychological support or therapy. Seeks to resolve issues related to mood, emotional stability, behavioral issues, adjustment issues, or problems with focus and concentration.

• #62 Subdural Hematoma Symptoms & Treatment | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/subdural-hematoma

  Recovery and rehabilitation for subdural hematomas is different for each individual. Depending on the severity and damage from the subdural hematoma, recovery can take weeks to months, and some people may even have life-long complications from it. […] There are several therapy options for rehabilitation, which include: […] Physiotherapy. Helps restore and correct issues with coordination, movement, and muscle weakness. […] Occupational therapy. Focuses on helping patients perform normal day to day tasks and activities again. […] Speech or language therapy. Focuses on helping patients to regain or improve speech or language issues. […] Psychological support or therapy. Seeks to resolve issues related to mood, emotional stability, behavioral issues, adjustment issues, or problems with focus and concentration.

• #63 Subdural haematoma – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/416

  Subdural haematoma (SDH) has a variable disease course, depending on size of haematoma, age of the patient, presenting neurological signs/symptoms, presence of underlying coagulopathy or neoplasm, and associated injuries. […] One week of prophylactic antiepileptic therapy (e.g., phenytoin, levetiracetam) should be considered in all cases of acute and acute-on-chronic SDH, according to the Brain Trauma Foundation guidelines. […] Aggressive reversal of coagulopathy should be accomplished in most patients with SDH who are taking anticoagulants. […] Surgical therapy is usually indicated for acute or chronic SDHs that are expansile or causing neurological deficit. Observation may be employed for small, stable SDHs that are not causing neurological compromise. […] Control of raised intracranial pressure using head-of-bed elevation, analgesics, intubation with anaesthetics and sedation, hyperosmolar treatment, barbiturates, or decompressive hemicraniectomy may be required. […] Treatment complications include early or delayed re-accumulation of SDH, seizures, vascular injury to cortical veins and arteries or dural sinuses adjacent to the haematoma, strokes, persistent neurological deficit, coma, and death.

• #64 Subdural haematoma – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/416

  Subdural haematoma (SDH) has a variable disease course, depending on size of haematoma, age of the patient, presenting neurological signs/symptoms, presence of underlying coagulopathy or neoplasm, and associated injuries. […] One week of prophylactic antiepileptic therapy (e.g., phenytoin, levetiracetam) should be considered in all cases of acute and acute-on-chronic SDH, according to the Brain Trauma Foundation guidelines. […] Aggressive reversal of coagulopathy should be accomplished in most patients with SDH who are taking anticoagulants. […] Surgical therapy is usually indicated for acute or chronic SDHs that are expansile or causing neurological deficit. Observation may be employed for small, stable SDHs that are not causing neurological compromise. […] Control of raised intracranial pressure using head-of-bed elevation, analgesics, intubation with anaesthetics and sedation, hyperosmolar treatment, barbiturates, or decompressive hemicraniectomy may be required. […] Treatment complications include early or delayed re-accumulation of SDH, seizures, vascular injury to cortical veins and arteries or dural sinuses adjacent to the haematoma, strokes, persistent neurological deficit, coma, and death.

• #65 Subdural haematoma – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/416

  Subdural haematoma (SDH) has a variable disease course, depending on size of haematoma, age of the patient, presenting neurological signs/symptoms, presence of underlying coagulopathy or neoplasm, and associated injuries. […] One week of prophylactic antiepileptic therapy (e.g., phenytoin, levetiracetam) should be considered in all cases of acute and acute-on-chronic SDH, according to the Brain Trauma Foundation guidelines. […] Aggressive reversal of coagulopathy should be accomplished in most patients with SDH who are taking anticoagulants. […] Surgical therapy is usually indicated for acute or chronic SDHs that are expansile or causing neurological deficit. Observation may be employed for small, stable SDHs that are not causing neurological compromise. […] Control of raised intracranial pressure using head-of-bed elevation, analgesics, intubation with anaesthetics and sedation, hyperosmolar treatment, barbiturates, or decompressive hemicraniectomy may be required. […] Treatment complications include early or delayed re-accumulation of SDH, seizures, vascular injury to cortical veins and arteries or dural sinuses adjacent to the haematoma, strokes, persistent neurological deficit, coma, and death.

• #66 Subdural haematoma – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/416

  Subdural haematoma (SDH) has a variable disease course, depending on size of haematoma, age of the patient, presenting neurological signs/symptoms, presence of underlying coagulopathy or neoplasm, and associated injuries. […] One week of prophylactic antiepileptic therapy (e.g., phenytoin, levetiracetam) should be considered in all cases of acute and acute-on-chronic SDH, according to the Brain Trauma Foundation guidelines. […] Aggressive reversal of coagulopathy should be accomplished in most patients with SDH who are taking anticoagulants. […] Surgical therapy is usually indicated for acute or chronic SDHs that are expansile or causing neurological deficit. Observation may be employed for small, stable SDHs that are not causing neurological compromise. […] Control of raised intracranial pressure using head-of-bed elevation, analgesics, intubation with anaesthetics and sedation, hyperosmolar treatment, barbiturates, or decompressive hemicraniectomy may be required. […] Treatment complications include early or delayed re-accumulation of SDH, seizures, vascular injury to cortical veins and arteries or dural sinuses adjacent to the haematoma, strokes, persistent neurological deficit, coma, and death.

• #67 Subdural haematoma – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/416

  Subdural haematoma (SDH) has a variable disease course, depending on size of haematoma, age of the patient, presenting neurological signs/symptoms, presence of underlying coagulopathy or neoplasm, and associated injuries. […] One week of prophylactic antiepileptic therapy (e.g., phenytoin, levetiracetam) should be considered in all cases of acute and acute-on-chronic SDH, according to the Brain Trauma Foundation guidelines. […] Aggressive reversal of coagulopathy should be accomplished in most patients with SDH who are taking anticoagulants. […] Surgical therapy is usually indicated for acute or chronic SDHs that are expansile or causing neurological deficit. Observation may be employed for small, stable SDHs that are not causing neurological compromise. […] Control of raised intracranial pressure using head-of-bed elevation, analgesics, intubation with anaesthetics and sedation, hyperosmolar treatment, barbiturates, or decompressive hemicraniectomy may be required. […] Treatment complications include early or delayed re-accumulation of SDH, seizures, vascular injury to cortical veins and arteries or dural sinuses adjacent to the haematoma, strokes, persistent neurological deficit, coma, and death.

• #68 Subdural haematoma – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/416

  Subdural haematoma (SDH) has a variable disease course, depending on size of haematoma, age of the patient, presenting neurological signs/symptoms, presence of underlying coagulopathy or neoplasm, and associated injuries. […] One week of prophylactic antiepileptic therapy (e.g., phenytoin, levetiracetam) should be considered in all cases of acute and acute-on-chronic SDH, according to the Brain Trauma Foundation guidelines. […] Aggressive reversal of coagulopathy should be accomplished in most patients with SDH who are taking anticoagulants. […] Surgical therapy is usually indicated for acute or chronic SDHs that are expansile or causing neurological deficit. Observation may be employed for small, stable SDHs that are not causing neurological compromise. […] Control of raised intracranial pressure using head-of-bed elevation, analgesics, intubation with anaesthetics and sedation, hyperosmolar treatment, barbiturates, or decompressive hemicraniectomy may be required. […] Treatment complications include early or delayed re-accumulation of SDH, seizures, vascular injury to cortical veins and arteries or dural sinuses adjacent to the haematoma, strokes, persistent neurological deficit, coma, and death.

• #69 Subdural haematoma – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/416

  Subdural haematoma (SDH) has a variable disease course, depending on size of haematoma, age of the patient, presenting neurological signs/symptoms, presence of underlying coagulopathy or neoplasm, and associated injuries. […] One week of prophylactic antiepileptic therapy (e.g., phenytoin, levetiracetam) should be considered in all cases of acute and acute-on-chronic SDH, according to the Brain Trauma Foundation guidelines. […] Aggressive reversal of coagulopathy should be accomplished in most patients with SDH who are taking anticoagulants. […] Surgical therapy is usually indicated for acute or chronic SDHs that are expansile or causing neurological deficit. Observation may be employed for small, stable SDHs that are not causing neurological compromise. […] Control of raised intracranial pressure using head-of-bed elevation, analgesics, intubation with anaesthetics and sedation, hyperosmolar treatment, barbiturates, or decompressive hemicraniectomy may be required. […] Treatment complications include early or delayed re-accumulation of SDH, seizures, vascular injury to cortical veins and arteries or dural sinuses adjacent to the haematoma, strokes, persistent neurological deficit, coma, and death.

• #70 Subdural hematoma – UF Health

  https://ufhealth.org/conditions-and-treatments/subdural-hematoma

  A subdural hematoma is an emergency condition. […] Emergency surgery may be needed to reduce pressure within the brain. This may involve drilling a small hole in the skull to drain any blood and relieve pressure on the brain. Large hematomas or solid blood clots may need to be removed through a procedure called a craniotomy, which creates a larger opening in the skull. […] Medicines that may be used depend on the type of subdural hematoma, how severe the symptoms are, and how much brain damage has occurred. Medicines may include: Diuretics (often given intravenously) and corticosteroids to reduce swelling; Anti-seizure medicines to control or prevent seizures. […] Outlook depends on the type and location of head injury, the size of the blood collection, and how soon treatment is started.

• #71 Subdural hematoma – UF Health

  https://ufhealth.org/conditions-and-treatments/subdural-hematoma

  Acute subdural hematomas have high rates of death and brain injury. Chronic subdural hematomas have better outcomes in most cases. Symptoms often go away after the blood collection is drained. Physical therapy is sometimes needed to help the person get back to their usual level of functioning. […] Seizures often occur at the time the hematoma forms, or up to months or years after treatment. But medicines can help control the seizures.

• #72 Treating Subdural Hematoma Symptoms | University of Utah Health

  https://healthcare.utah.edu/neurosciences/neurosurgery/subdural-hematoma

  With effective treatment, the vast majority of chronic subdural hematomas will go away for patients. Many patients will also notice a reduction in symptoms such as decreased headaches, improved walking, and more energy. After the initial treatment, your neurosurgeon will conduct follow-up testing. If the hematoma returns or remains in your brain, your doctor will discuss additional treatment options and next steps with you.

• #73 Treating Subdural Hematoma Symptoms | University of Utah Health

  https://healthcare.utah.edu/neurosciences/neurosurgery/subdural-hematoma

  People with an acute subdural hematoma typically do not need treatment because the hematoma will break down in the body over time. However, in some cases, following a head injury, an acute subdural hematoma will need to be treated immediately with surgery to relieve pressure on the brain. […] Treatment options for chronic (non-acute) subdural hematomas include the following: Medication. This may help resolve the subdural hematoma. Brain surgery (craniotomy). This is a surgical procedure that opens the skull to remove the subdural hematoma. Middle meningeal artery (MMA) embolization, which involves guiding a catheter into an artery that is supplying blood to the subdural hematoma and releasing specialized pellets to stop the bleeding. […] Chronic subdural hematomas, in particular, can be complicated and may recur after surgery. Some patients may need a combination of MMA embolization, surgery, and medication. Your neurosurgeon will discuss your options and recommend a personalized treatment plan to ensure the best outcome for your health.

• #74 Treatment combination for subdural hematoma reduces recurrence risk | Cornell Chronicle

  https://news.cornell.edu/stories/2024/11/treatment-combination-subdural-hematoma-reduces-recurrence-risk

  A novel combination of surgery and embolization used to treat subdural hematomas, bleeding between the brain and its protective membrane due to trauma, reduces the risk of follow-up surgeries, according to researchers at Weill Cornell Medicine and University at Buffalo. […] The finding is based on EMBOLISE, a multi-center, randomized clinical study that compared chronic subdural hematoma recurrence rates in patients treated with surgery and middle meningeal artery (MMA) embolization versus current standard of care with surgery alone. […] This trial provides evidence that adding MMA embolization should be a new standard of care for one of the most common neurosurgical conditions we see, said co-lead author and pioneer of MMA embolization, Dr. Jared Knopman, director of Cerebrovascular Surgery and Interventional Neuroradiology, an associate professor of neurological surgery at Weill Cornell Medicine and a neurosurgeon at NewYork-Presbyterian/Weill Cornell Medical Center.

• #75 Treatment Options for Chronic Subdural Hematoma

  https://www.apexbrainandspine.com/post/exploring-treatment-options-for-chronic-subdural-hematoma

  Advancements in medical technology have led to the development of minimally invasive techniques for treating cSDH. […] An endovascular approach that involves access through the artery of the wrist or leg to block, or embolize, the small artery that gives blood supply to the cSDH. […] After surgical intervention for chronic subdural hematoma, patients require careful postoperative management to ensure a smooth recovery and reduce the risk of recurrence. […] The choice of treatment for chronic subdural hematoma depends on several factors, including the patient’s age, overall health, the size and location of the hematoma, neurological symptoms, and any underlying medical conditions. […] Whether through surgical evacuation, minimally invasive techniques, or observation, the treatment approach selected should be tailored to the patient’s unique circumstances. […] Early detection, accurate diagnosis, and timely intervention are crucial to prevent the progression of symptoms and improve patient outcomes.

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