SUBDURAL HAEMATOMA

Subdural hematoma is a buildup of blood on the surface of the brain. The blood builds up in a space between the protective layers that surround your brain. In a subdural hematoma, the blood seeps between the dura and the arachnoid layers. It collects inside the brain’s tough outer lining.This bleeding often comes from a blood vessel that breaks within the space around the brain.This most often happens because of a head injury. The injury can be mild. The blood may press against the brain and damage the tissue. A subdural hematoma can be life-threatening.

TYPES:

Acute Subdural Haematoma-  It is a collection of blood between the brain and dura. It is due to injury to the cortical veins and often due to laceration of cortex of brain which bleeds and blood gets collected in the subdural space forming a haematoma. Here haematoma is extensive and diffuse. There is no lucid interval. There is severe primary brain damage.

FEATURES :

Loss of consciousness occurs immediately after trauma and is progressive.  Convulsion is common.

Features of raised intracranial pressure

• high BP
• bradycardia
• Vomiting
• Focal neurological deficits or hemiparesis can occur.

 CT scan shows concavo-convex lesion.

CHRONIC SUBDURAL HAEMATOMA

 It is due to the rupture of veins between dura and brain (cerebral hemispheres), causing gradual collection of blood in subdural space.

It is commonly seen in elderly people following any minor trauma like fall, slipping.

In elderly people, brain atrophies and even minor injuries can cause shearing and bleeding from these veins.  Blood collects gradually over 2–6 weeks. Plasma and cellular components get separated. Eventually cellular part gets absorbed leaving only fluid component. It is called as chronic subdural hygroma.

Usual haematoma collection is 60–120 ml. Often in 50% of cases, it is bilateral.

CLINICAL FEATURES

 Common in old age, with history of minor trauma. Patient presents with confusion, disorientation, gradually with altered level of consciousness and drowsiness.

• Extradural haematoma. Note the biconvex configuration of the haematoma; (B1 and B2) CT scan head showing extradural haematoma with biconvex lesion.
• features of intracranial hypertension, features of coning develops. x Extensor plantar response and pupillary changes develop eventually

INVESTIGATIONS

• CT scan (shows concavo-convex lesion)
• Serum electrolytes.
• Blood grouping and cross matching
• MRI
• X RAY OF SKULL

HOMOEOPATHIC MANAGEMENT:

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