Subdural haematoma

A subdural haematoma is bleeding inside the brain usually caused by a head injury. It can be very serious and usually has to be treated with surgery.

Symptoms of a subdural haematoma

A subdural haematoma can happen after a head injury.

The symptoms may start straight away, or come on gradually over a few weeks.

Symptoms of a subdural haematoma include:

• a bad headache that does not get better after taking painkillers
• feeling and being sick
• confusion and memory problems
• changes in personality, such as being unusually aggressive
• drowsiness
• slurred speech and problems with swallowing
• problems with vision, like blurred or double vision
• loss of balance and having falls
• having problems moving one side of your body (paralysis)
• seizures (fits)
• loss of consciousness – the person affected may not respond when you talk to, or touch them; this may just last for a few moments or could be much longer

Go to A&E if:

You or your child have had a head injury and have:

• been knocked out but have now woken up
• vomited (been sick) since the injury
• a headache that does not go away with painkillers
• a change in behaviour, like being more irritable or losing interest in things around you (especially in children under 5)
• been crying more than usual (especially in babies and young children)
• problems with memory
• been drinking alcohol or taking drugs just before the injury
• a blood clotting disorder (like haemophilia) or you take medicine to thin your blood
• had brain surgery in the past

You should also go to A&E if you think someone has been injured intentionally, or you’re worried about yourself or your child and you’re not sure what to do.

Call 112 if:

Someone has hit their head and has:

• been knocked out and has not woken up
• difficulty staying awake or keeping their eyes open
• a fit (seizure)
• fallen from a height more than 1 metre or 5 stairs
• problems with their vision or hearing
• a black eye without direct injury to the eye
• clear fluid coming from their ears or nose
• bleeding from their ears or bruising behind their ears
• numbness or weakness in part of their body
• problems with walking, balance, understanding, speaking or writing
• hit their head at speed, such as in a car crash, being hit by a car or bike or a diving accident
• a head wound with something inside it or a dent to the head

Also call 112 if you cannot get someone to A&E safely.

Do not drive to A&E.

The person you speak to at 112 will give you advice about what to do.

Treatments for subdural haematoma

If you’ve had a serious head injury, you may need a brain scan, such as a CT scan or MRI scan, to check if you have a subdural haematoma.

If you have a small haematoma that’s only causing mild symptoms, you may be monitored and given no treatment, or given medicines to reduce the swelling in your brain.

But most people with a haematoma will need surgery to remove it.

There are 2 ways surgery can be done:

• the surgeon cuts open a small section of your skull to remove the haematoma and the cut is then sealed
• the surgeon drills some small holes (called Burr holes) in your skull, and the haematoma is sucked out through the holes

Recovering from a subdural haematoma

Subdural haematomas can be very serious injuries and even with the best care, there is a high risk of death.

People with serious subdural haematomas can be left with long-term or permanent problems, such as problems with walking, talking and thinking. They may also have seizures (fits).

While it may not be possible to make a full recovery, you’ll be supported by a range of healthcare professionals who will offer treatments and therapies that can help.

These may include:

• physiotherapy – a physiotherapist can teach you exercises that may make it easier for you to move around
• occupational therapy – occupational therapy aims to improve your ability to do everyday tasks
• speech and language therapy (SLT) – a therapist can help you with any difficulties you may have with speaking, eating and swallowing