Subdural Hematoma

2015

Subdural 

Hematoma

www.

nshealth

.ca

Patient & Family Guide

1

Subdural Hematoma

This pamphlet will help you and your family 

learn about subdural hematomas, as well as 

possible tests, treatments, and other care that 

you may need. 

What is a subdural hematoma? 

The brain is protected by a tough outer covering 

called the dura. Above and below the dural 

covering are many blood vessels that supply 

blood to the brain. If a blood vessel (usually 

a vein) is torn below the dura, blood collects 

between the dura and the surface of the brain. 

This is called a subdural hematoma. 

Skull

Dura

Hematoma

2

Acute subdural hematoma 

An acute subdural hematoma happens when the 

blood collects quickly, within hours of the injury. 

Chronic subdural hematoma 

Blood may continue to leak slowly over the 

brain for a period of time (days or weeks). This is 

called a chronic subdural hematoma. A person 

becomes aware of the symptoms over a period 

of days or weeks.

What causes a subdural hematoma? 

Trauma (as a result of an accident, such as a 

motor vehicle crash, fall, or blow to the head) 

can cause a subdural hematoma. People at risk 

of having a subdural hematoma include those 

taking blood thinners, the elderly, and those 

susceptible to falls. Many people with chronic 

subdural hematoma can’t remember hitting 

their head. 

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What are the symptoms? 

Symptoms may include: 

 › Confusion 

 › Decreased memory 

 › Seizures 

 › Weakness or numbness affecting the arm, 

leg, or face 

 › Worsening headache 

 › Difficulty speaking or swallowing 

 › Difficulty walking 

 › Vomiting 

 › Drowsiness 

 › More falls 

 › Personality changes, such as becoming 

withdrawn 

Possible tests 

A 

CT (X-ray) 

of your head 

is needed to 

determine the size 

and location of 

the hematoma. 

This will help the 

doctors decide on 

the best treatment 

for you. 

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Blood tests are needed 

to find out if you have 

any health problems. 

If you 

do not wish to 

receive blood for any 

reason, please tell your 

doctor or nurse before 

your operation. Your doctor will discuss possible 

options with you. 

How will the hematoma be treated? 

The neurosurgeon will discuss the options for 

treatment with you and your family. 

Medical treatment 

If the clot is small and your symptoms are not 

severe, your doctor may prescribe a steroid 

medication. This will help prevent the clot from 

getting bigger, and allow time for the body to 

reabsorb any blood that has collected. When 

you are stable, you will be discharged home with 

supervision. 

Arrangements are usually made for outpatient 

follow-up in the Neurosurgery Clinic. 

 If symptoms get worse before your follow-

up appointment, contact your family doctor 

or go to the nearest Emergency Department 

immediately.

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Surgical treatment 

The neurosurgeon will drill 1-2 small holes (burr 

holes) in your skull to drain the blood. If the clot 

is too large or is solid, a bigger operation may be 

needed. Your neurosurgeon will talk about this 

with you. 

The operation 

•  Your family may wait in the neurosurgery 

waiting room on Unit 7.3. 

•  You will be taken to the Operating Room (OR) 

on a stretcher. 

•  The anesthetist will place an intravenous 

(IV) in your arm. This is a small plastic tube 

through which medications will be given to 

put you to sleep. 

•  The surgery will take 1-2 hours. You will then 

be taken to the recovery area. 

•  As soon as the surgery is over, your doctor 

will go to the waiting area to discuss your 

condition with your family. 

If you have any questions, please ask. 

We are here to help you.

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After surgery 

•  After spending time in the recovery area, you 

will either return to your room or be taken to 

the Intermediate Care Unit on 7.3. 

•  Sometimes a drain is placed underneath 

the skin near the site of the operation for 

24-48 hours to collect any blood. The nurse 

and doctor will be checking the amount of 

drainage closely. 

•  A small bandage will cover the operation 

site(s). 

•  You may be asked to remain flat in bed for 

24-48 hours. This will depend on the doctor’s 

assessment of your condition. 

•  A catheter may have been placed in your 

bladder during surgery. It will be removed as 

soon as possible. 

•  Your nurses and doctors will check you 

regularly for any change in your condition 

(such as increased headache, loss of strength 

in an arm or leg, speech problems, or 

drowsiness). 

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Special considerations 

If you were taking a blood thinner, such as 

warfarin or enteric-coated ASA, it may be 

stopped temporarily. Your neurosurgeon will 

consult with other doctors to help make this 

decision. 

After surgery, your doctor may prescribe a 

steroid called dexamethasone for a short time. 

The amount will be slowly lowered at the 

direction of the neurosurgeon. Dexamethasone 

may elevate your blood sugars. If you have 

diabetes, you may have to check your blood 

sugars more closely. 

There will be stitches or staples at the site where 

the hematoma was drained. These stitches 

will usually dissolve on their own. If you have 

staples that need to be removed, you will need 

to see your family doctor 7-10 days after your 

operation.   

Possible complications 

The surgical team will talk with you about 

possible complications related to surgery. 

Subdural hematomas may happen again and 

further surgery may be needed. 

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Discharge planning 

Your neurosurgeon will recommend whether 

you can return home or will need further 

assistance in either a hospital closer to home or 

a rehabilitative setting. 

You may or may not need follow-up with your 

neurosurgeon. They will discuss this with you. A 

report of your hospital stay will be sent to your 

family doctor. 

How will I know if the subdural 

hematoma has returned? 

You may find that the symptoms that you had 

before surgery return. 

These symptoms may include: increased 

headaches, confusion, problems with 

walking, weakness in an arm or leg, speech 

problems, or drowsiness. 

If you or your family notices any of these 

symptoms, return to your family doctor or go to 

an Emergency Department immediately. 

Notes:

Looking for more health information?

Contact your local public library for books, videos, magazines, and other resources. 

For more information go to http://library.novascotia.ca

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Nova Scotia Health Authority

www.nshealth.ca

Prepared by:

 Neurosurgery ©

Illustration by:

 LifeART Emergency 2 and Health Care 1 Images, Copyright © 1994, 

TechPool Studios Corp. USA

Designed by: 

Nova Scotia Health Authority, Central Zone Patient Education Team

Printed by:

 Dalhousie University Print Centre

The information in this brochure is for informational and educational purposes only.

The information is not intended to be and does not constitute healthcare or medical advice.

If you have any questions, please ask your healthcare provider.

WL85-1156 Updated December 2015

The information in this pamphlet is to be updated every 3 years or as needed.

The information in this brochure is for informational and educational purposes only.

The information is not intended to be and does not constitute healthcare or medical advice.

If you have any questions, please ask your healthcare provider.

The information in this pamphlet is to be updated every 3 years or as needed.

WL85-1156 Updated December 2015

The information in this pamphlet is to be updated every 3 years or as needed.

The information in this pamphlet is to be updated every 3 years or as needed.