Acute Subdural Hematoma
- DOI:
- 10.1093/med/9780190936259.003.0003
Acute subdural hematomas are collections of acute blood in the subdural space. They usually present as a result of significant head trauma. They can occur spontaneously in relationship to an underlying hemorrhagic lesion such as tumor, arteriovenous malformation, or aneurysm. They are more likely to be associated with cortical injury than the epidural hematoma. Neurological symptoms on presentation are related to the underlying brain injury and/or mass effect. Acute subdural blood on CT scan is hyperdense, in a crescent shape, along the inner dural surface. Emergent surgical intervention via craniotomy is indicated in patients with at least 10 mm in thickness or at least 5 mm shift, or elevated ICP, or pupillary dilatations suggesting herniation, or progression of deficit based on the Glasgow Coma Score. Conservative management of small acute subdural hematomas may be done in select situations that include proper ICU monitoring for ICP elevations and neurological deteriorations.
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