According to Harvard Health, a subdural hemorrhage (SDH) occurs when a blood vessel at the surface of the brain bursts, causing blood to pool directly underneath the outermost layer of the meninges, or the layers of tissue that protect the brain. The meninges consists of:
- Pia mater: Innermost layer covering the brain
- Arachnoid: Middle layer
- Dura mater: Outermost layer attached to the skull
A subdural hemorrhage occurs between the arachnoid and dura mater of the meninges. Also called a subdural hematoma, it can place pressure on the brain, leading to complications or death.
Causes of Subdural Hemorrhage
Patients typically suffer a subdural hemorrhage as the result of sudden head trauma, such as impact from a car accident or physical abuse. Those who take blood thinners or have seizures may also develop an SDH from minor head trauma. An SDH can occur in two ways.
- Acute SDH: Bleeding occurs quickly and often leads to rapid loss of consciousness or death
- Chronic SDH: Bleeding occurs over an extended period, slowing the progression of symptoms
As people age, their blood vessels become more fragile and susceptible to injury, so the elderly may experience subdural bleeding more easily than younger people. Doctors often diagnose older people with chronic hemorrhages, as their sensitivity to impact makes them especially prone to brain injuries.
Signs and Symptoms of Subdural Hemorrhage
Because of the rapid bleeding associated with acute SDH, symptoms typically occur immediately and progress swiftly. The patient may experience the sudden onset of a severe headache, serious vision changes, and seizures before losing consciousness.
Individuals with chronic SDH, especially the elderly and family members who care for them, may find identifying the signs of the condition more challenging. Due to their slowly developing nature, medical providers may mistake them for early signs of dementia. Cedars Sinai lists other symptoms of SDH, which may include:
- Trouble with balance or mobility
- Nausea or vomiting
- Intermittent weakness or numbness
- Trouble speaking
- Vision problems
- Headache and dizziness
Testing for Subdural Hemorrhage
To diagnose an SDH, a medical provider will ask the patient questions about the cause of the bleeding and their symptoms and may ask them to perform basic tasks, such as touching their nose. If they suspect an SDH or other type of brain injury, they will request specific testing to confirm the diagnosis and the severity of the condition. Tests may include blood draws and imaging tests, such as a CT, MRI, or angiography. These testing methods can help doctors establish the cause, extent, and location of the bleeding and determine the appropriate course of treatment for the patient.
How Doctors Treat Subdural Hemorrhage
Treatment of an SDH varies greatly based on type, location, and severity. Typically, doctors recommend surgery to drain fluid and alleviate compression of the brain. According to Healthline, doctors usually perform one of two surgeries.
An acute SDH may require a craniotomy, in which surgeons remove part of the skull to drain the hemorrhage, to save the patient’s life. Patients with chronic SDH may instead undergo a burr hole procedure, in which surgeons remove the hemorrhage through a much smaller opening in the skull. After surgery, doctors may prescribe medications to prevent further bleeding and minimize swelling.
Prognosis for Subdural Hemorrhage
While those with a chronic SDH may experience better odds of survival, both types carry potentially life-threatening risks. Cleveland Clinic explains that prognosis varies based on age, the immediacy of care, and the severity of the head injury.
Acute SDH cases account for the highest level of morbidity. Approximately half of all patients who experience an acute SDH survive, particularly younger individuals. Of those, many suffer permanent brain injuries.
While patients with chronic SDH have the best odds of survival, the condition may cause lasting brain damage or death if not treated immediately. Older people who recover from chronic SDH have a greater chance of developing the condition again in the future.
How to Seek Help for Nursing Home Abuse
Recovery from an SDH requires consistent care and monitoring, both in the hospital and when the patient returns home. If you suspect that nursing home staff contributed to your loved one’s condition or did not responsibly manage their rehabilitation from an SDH, you should notify administrative staff right away. Report all known incidences, as well as other concerns you have about your loved one’s condition or the management of the facility.
Families often have trouble choosing a nursing home for their loved one. Even when outward appearances make a facility seem ideal, family members may later discover that their loved one experienced mistreatment at the hands of the staff they trusted to provide care. If you suspect that your spouse, parent, or another member of your family suffered a subdural hemorrhage as the result of nursing home abuse, an attorney can help you determine if you are entitled to compensation. Contact Pintas & Mullins Law Firm today to discuss your case with our legal team.