Subdural hematoma is a very dangerous injury!

Hematoma is a type of injury that is characterized by a limited accumulation of blood with closed and open injuries of tissues and organs with vascular rupture. In this case, a cavity is formed at the site of injury, containing liquid or coagulated blood.

But if such damage to the external body covers is practically without a trace, and the doctor will save the ointment from bruises and bruises, some types of intracranial bruises threaten serious brain damage and even death. Subdural hematoma is a volumetric accumulation of blood, located between the arachnoid and the dura mater, causing compression of the brain. For the most part, the subdural hematoma is the result of a traumatic brain injury.

Significantly less infringement occurs when there is a vascular pathology of the brain - hypertension, arterial aneurysm, arteriovenous malformations, etc. In some cases, the emergence of subdural hematoma is triggered by the use of anticoagulants.

Isolated subdural hematomas account for approximately 2/5 of the total number of intracranial traumatic disorders and occupy the first place among various species of hematomas. In patients with light craniocerebral trauma, acute subdural hematomas are found in about 1-5% of cases, and in severe craniocerebral trauma - in 9-22%.

According to statistical data, the ratio of such violations in representatives of different sexes is 3: 1.That is, subdural hematoma is more often diagnosed in men than in women. At the same time, hematomas are characteristic for all age categories, but most often they are found in people over forty.

Types and causes of subdural hematoma of the head

As a rule, such disorders arise from head injuries of varying severity. Acute subdural hematoma often occurs as a result of a severe form of craniocerebral trauma. Other forms of hematomas are diagnosed with relatively minor injuries. Unlike the epidural type of hematoma, subdural hemorrhages occur not only on the side of the traumatic agent, but also on the opposite side, with the same frequency.

Specialists share all kinds of subdural hematomas in three separate forms, depending on the rate at which the symptoms appear. Thus, the following are isolated:

• acute subdural hematoma - clinical signs of impairment appear within 3 days after trauma;
• subacute subdural hematoma is characterized by the appearance of symptoms 4-14 days after injury;
• chronic subdural hematoma - signs of impairment may occur several weeks and even months after the injury.

Mechanisms for the formation of this violation are different. As a rule, acute lamellar subdural hematoma is formed as a result of severe craniocerebral trauma. In the development of subacute and chronic hematomas, a significant role is played by secondary hemorrhages, resulting from a violation of the integrity of the vessels under the influence of various factors.

Symptoms of subdural hemorrhage

The clinical symptoms of this disorder are extremely variable. Together with their volume, localization of bleeding, the rate of formation, peculiarities of spread and other factors, this is also due to frequent and severe concomitant brain damage. Often, due to the anti-blow mechanism, subdural hematomas are bilateral.

The clinical picture, characteristic for subdural hemorrhage, consists of local, cerebral and secondary stem manifestations. Typically, the presence of a "light" gap - the period after the traumatic brain injury, when the symptoms of the violation are completely absent. The duration of such an asymptomatic period with subdural hematoma varies from several minutes and hours to several days. In the case of a chronic form of disorder, this interval can reach several months and even years.

In this case, the chronic form is characterized by the fact that the clinical manifestations of the disorder can be provoked by various factors. This includes additional injuries, fluctuations in blood pressure and much more. In the presence of concomitant bruises, a "light" gap is often absent. The subdural hematoma is characterized by pronounced undulation and gradualness in the change of consciousness, however some patients suddenly fall into a coma.

Among the symptoms of this disorder are present such as psychomotor agitation, epileptic seizures, generalized convulsive paroxysms. Almost a constant sign of subdural hematoma can be considered a headache, which is often accompanied by vomiting.

Treatment of the disease

Treatment of this disorder can be carried out both with the help of conservative and surgical techniques. The choice of treatment tactics for each specific case depends on the volume of the hematoma, the phase of its development and the current state of the patient. Subdural hematoma, which is treated surgically, occurs relatively more often than forms of disturbance that are susceptible to conservative treatment.

Indications for surgical intervention:

• is an acute form of subdural hemorrhage, causing displacement and compression of the brain. With this diagnosis, the operation should be performed as soon as possible after traumatic brain injury. The earlier the hematoma is removed, the better the final outcome will be.
• subacute subdural hematoma, at which there is an increase in focal symptoms, and signs of intracranial hypertension appear.

In all other cases, the decision to conduct an operation is based on a combination of clinical symptoms and other diagnostic data.

Possible consequences of

In prognostic terms, the acute form of subdural hemorrhage is often less favorable than epidural hematoma. This is due to the fact that subdural hematoma occurs, as a rule, with primary severe brain damage, and is also accompanied by a rapid rate of brain displacement and infringement of stem structures.

The consequences of such a violation, in most cases, depend on timely diagnosis and the correct treatment method chosen. Unfortunately, for today acute acute subdural hematomas have a relatively high lethality, and among the surviving patients there is a significant deep disability. An important role in predicting the consequences of this disorder is played by such factors as the age of the victims, the amount of subdural hemorrhage and the timeliness of the treatment.