MED INSIDERDR RIA MASLOG

Subdural Hematoma


We hear this term oftentimes during trauma and accidents, when the patient has subdural hematoma. 

And what is this all about? Our textbook of Pediatrics by Dr Fe Del Mundo says that subdural hematoma is a collection of bloody fluid between the dura and the brain. 

There is bleeding that usually results from the rupture of cortical veins bridging the subdural space.

So what happens inside the skull during severe trauma to the head? 

There could be an appearance of a clot and initially, the clot is dark red in color and in the form of a solid clot. Then it breaks down resulting into fluid that maybe straw to chocolate in color. This will begin to organize and a membrane will later envelop the clot which in time will result to be a space-occupying lesion.

Clinically, the infants with subdural hematomas will present the following symptoms: failure to thrive, anorexia, irritability, frequent vomiting, enlarging head, and seizures

In older children, the manifestations are similar to those of the adults. These are: increased intracranial pressures, gradual change in personality, headaches,  seizures, and or rapid deterioration in consciousness

If left untreated, the prognosis is not good. In infants, it is a much poorer prognosis than those of the postmeningitic type. 

The ultimate outcome depends upon the extent of damage sustained by the brain.