CSDH: Symptoms, Risks, and Treatment

What is Chronic Subdural Hematoma?

A chronic subdural hematoma (CSDH) refers to a gradual accumulation of blood on the brain’s surface, often developing weeks after a mild head trauma.

This condition occurs when blood gradually accumulates between the brain and its outer membrane (the dura mater), with the bleeding persisting over several days or weeks and leading to increased pressure on the brain.

This condition is often overlooked because the initial injury might seem trivial — a small fall, a bump on the head, or slipping in the bathroom.

But in elderly people or those on blood thinners, such minor injuries can lead to dangerous brain bleeds that show symptoms much later.

Who Is at Risk for CSDH?

Chronic Subdural Hematoma is more common in:

✅ Older adults over the age of 60 are more vulnerable because of brain shrinkage associated with aging

✅ People on blood thinners (Aspirin, Warfarin, Apixaban)

✅ Chronic alcohol users

✅ Frequent fallers (Parkinson’s, balance issues)

✅ Individuals with previous head injury or brain surgery

Even if there’s no immediate sign of damage, these individuals should be watched closely after any fall or bump to the head.

Common Symptoms of CSDH

The tricky part about chronic subdural hematoma is that symptoms often appear gradually. Some of the key warning signs include:

✅ Constant or worsening headache
✅ Forgetfulness, confusion, or memory loss
✅ Unsteady walking or balance issues
✅ Weakness or numbness in arms or legs
✅ Personality changes
✅ Daytime sleepiness
✅ In severe cases: seizures or loss of consciousness

If any of these symptoms appear weeks after a minor head injury, especially in the elderly, get a brain scan immediately.

Dr. Ganesh Veerabhadraiah

Consultant – Neurosurgeon, Neurointerventional Surgery, Spine Surgeon (Neuro)
23+ Years Experience Overall (17+ years as Neuro Specialist)

Available for Consultation: Jayanagar 9th Block & Kauvery Hospital, Electronic City

Real-Life Example from My Practice

A 72-year-old gentleman visited my clinic with mild memory loss and left-hand weakness.

His family thought it was aging or early dementia. On detailed history, we found he had a fall in the bathroom 3 weeks prior.

Brain imaging through a CT scan showed a significant long-standing subdural blood collection.

We performed a burr hole surgery, drained the blood, and he recovered within a few days. His memory and walking improved dramatically.

Diagnosis: CT Scan Is Key

Identifying a chronic subdural hematoma is typically straightforward and does not require complex procedures.

A non-contrast CT scan of the brain is the most common and effective tool. It takes just 5–10 minutes and clearly shows the bleed.

Sometimes an MRI scan is used for deeper analysis, but a CT is usually enough to confirm the diagnosis.

Treatment: Simple and Safe

The good news is that chronic subdural hematoma is highly treatable.

Treatment options include:

1.Observation – If the hematoma is small and not causing pressure, we monitor it with repeat scans.

2.Burr Hole Surgery – A small hole is made in the skull under local or general anesthesia. Blood is drained, pressure is relieved, and recovery is usually quick.

Most patients are discharged within 2–3 days after surgery and return to normal activities within weeks.

Post-Surgery Recovery

After surgery, patients are monitored for 24–48 hours. A follow-up scan ensures the blood is fully drained. Medications include painkillers, antibiotics, and sometimes seizure-prevention drugs.

Family members are advised to monitor for recurrent symptoms and to follow fall prevention practices at home.

Prevention Tips for Chronic Subdural Hematoma

You can reduce the risk of CSDH by:

✅ To reduce the risk of falls, install support bars in bathrooms, place non-slip mats, and ensure proper lighting at night

✅ Wearing helmets when riding two-wheelers

✅ Managing blood pressure and sugar levels

✅ Reviewing blood thinner use with your doctor

✅ Acting fast after head injuries, even if mild

✅ Understanding early warning signs

Awareness and timely action are your best defense.

Final Takeaway

Chronic Subdural Hematoma may be silent, but it is very treatable if diagnosed early. Don’t ignore unusual symptoms like headache, confusion, or imbalance — especially in older adults after a fall. A basic CT scan can be life-saving by detecting critical issues early.

Seek prompt evaluation from a neurosurgeon if you or someone close experiences these symptoms.

FAQs:

1. What are the early warning signs of chronic subdural hematoma?

Common symptoms include headache, confusion, memory loss, and balance issues. These signs may appear weeks after a minor head injury.

2. How does a chronic subdural hematoma develop?

It occurs when blood slowly collects between the brain and dura after mild trauma, creating pressure over time.

3. Can a CT scan detect chronic subdural hematoma?

Yes, a non-contrast CT scan is quick, accurate, and the standard method for detecting CSDH.

4. What is the treatment for chronic subdural hematoma?

Most cases are treated with burr hole surgery to drain the blood and relieve pressure on the brain.

5. How can chronic subdural hematoma be prevented?

Prevent falls, manage blood thinners, and seek medical help after any head injury, even if mild.

Tags:BackSurgeryFacts, BustingSpineMyths

admin

Neurowellness-Brain and Spine care

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