Chronic Subdural Hematoma (CSDH): The Silent Brain Bleed You Shouldn’t Ignore

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.

5 Myths of Spine Surgery You Should Be Aware

A 54-year-old gentleman came to me with severe leg pain and numbness that had been worsening for months. He had a slipped disc and spinal stenosis—but instead of seeing a specialist, he believed a common myth: “Spine surgery causes paralysis.”

He delayed surgery, tried everything else—from massages to home remedies—and by the time he returned, it was too late. The nerve damage had progressed.

We performed the surgery to relieve pain and to help him sit, but he never regained full limb movement. He lost strength in both legs, could not walk normally again, and required bowel and bladder care for the rest of his life.

Hello and welcome! I’m Dr. Ganesh Veerabhadraiah, Senior Consultant Neurosurgeon. Today, let’s clear the air around one of the most misunderstood medical topics—spine surgery.

Many people suffer silently with back or neck pain because of fear—fear that spine surgery will leave them worse off. But the truth is: modern spine surgery is safer, faster, and more effective than ever before.

Learn more : Minimally Invasive Spine Surgery: What You Need to Know

Top 5 Spine Surgery Myths—Debunked with Facts and Hope

1. Myth: Spine surgery always leads to paralysis

This is the biggest and most harmful myth. The fear of paralysis stops many patients from getting the help they actually need. But here’s the truth: spine surgery today is incredibly advanced.

With tools like high-resolution MRI, intraoperative navigation, and microscopic surgery, experienced neurosurgeons can perform procedures with millimeter precision.

In reality, the risk of paralysis is extremely low, especially in elective surgeries like discectomy, TLIF, or ACDF. Many patients regain lost movement and prevent future nerve damage thanks to timely surgery.

So, spine surgery doesn’t paralyze people—it actually protects their nerves from further injury.

2. Myth: You should avoid spine surgery at all costs

Many people try to manage back or neck pain with medications, physiotherapy, or injections—and rightly so; that’s the first step. But sometimes, non-surgical treatments don’t work.

In cases of severe disc prolapse, spinal stenosis, or spondylolisthesis, delaying surgery can lead to permanent nerve damage—including foot drop, bladder dysfunction, or chronic weakness.

Spine surgery isn’t something to be feared—it’s something to be done wisely, when needed. It’s not the last resort—it’s the right tool for the right patient, at the right time.

3. Myth: After spine surgery, you can never walk normally again

This is a misconception. In fact, most of my patients walk the same day or the next day after minimally invasive or even conventional spine surgeries.

Take microdiscectomy or TLIF procedures—we use microscopes, small incisions, and gentle handling of the nerves. As soon as the pressure on the nerve is released, the patient often says, “Doctor, the leg pain is gone!”

With proper post-op care and physiotherapy, walking improves, posture improves, and mobility is restored. So, spine surgery helps you walk better, not worse.

4. Myth: All spine surgeries are done with large cuts and long hospital stays

That may have been true 20 years ago—but not today.

Today, we use minimally invasive techniques, microscopes, drills, and advanced C-arm machines for many spine surgeries.

This means:

• Small incisions
• Microscopic or endoscopic access
Minimal muscle damage
• Faster recovery

Patients often stay in the hospital for just 1 or 2 days, and many return to desk jobs in 2–3 weeks.

So, spine surgery doesn’t mean big scars or bedrest for months—it’s often quicker than people think.

5. Myth: Once you have spine surgery, you’ll always need more surgeries

Many people say, “If I get one spine surgery, I’ll end up with 3 more later.” That’s a myth—and a fear-based assumption.

The truth? If the underlying problem is diagnosed correctly, properly identified and treated, and if the patient follows good posture, physiotherapy, and avoids strain—one surgery is often enough.

In fact, I’ve seen patients do extremely well for 10–15 years post-surgery without needing anything more.

Yes, there are rare cases of recurrence, but that depends on patient lifestyle, body mechanics, and problems at other spinal levels. So, spine surgery doesn’t mean a lifetime of operations.

Read More : Top10 Essential Tips for a Healthy Spine

About Dr. Ganesh Veerabhadraiah

Dr. Ganesh Veerabhadraiah is a Senior Consultant Neurosurgeon with extensive experience in advanced brain and spine surgeries. He specializes in minimally invasive procedures and is dedicated to providing patients with the best possible outcomes.

Stay updated with the latest insights on spine health, treatment options, and expert advice from Dr. Ganesh Veerabhadraiah.

Final Thoughts

Back pain, neck pain, disc problems, or nerve compression don’t mean you have to suffer forever. Spine surgery, when done at the right time, by the right hands, is safe and life-changing.

Don’t let myths keep you in pain.

Consult a neurosurgeon or qualified spine surgeon in Jayanagar or Electronic City, get your MRI reviewed, and understand your options.

Book a Consultation

Ready to take the next step towards a pain-free life?

📍 For appointments in Electronic City:
Call: 74115 71002

📍 For appointments in Jayanagar:
Call: 72596 69911

FAQs:

1. Is spine surgery always risky and leads to paralysis?

No, modern spine surgery is highly advanced with minimal risks. Techniques like minimally invasive surgery have significantly reduced complications, making procedures safer than ever.

2. Will I need multiple surgeries after the first spine operation?

Not necessarily. If the underlying issue is correctly diagnosed and treated, and post-operative care is followed diligently, many patients do not require additional surgeries.

3. Does spine surgery require a long hospital stay and recovery period?

With advancements in surgical techniques, many spine surgeries are now minimally invasive, leading to shorter hospital stays—often just 1-2 days—and quicker recovery times.

4. Is spine surgery only for older adults?

 No, spine surgery is determined by the specific spinal condition, not age. Younger patients with certain spinal issues may also benefit from surgical intervention.

5. Can I resume normal activities after spine surgery?

Yes, most patients return to their regular activities post-surgery. Physical therapy and adherence to medical advice play a crucial role in a successful recovery.

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