Subdural Hematoma
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[edit] Subdural hematoma
Another cause of headaches can be a subdural hematoma, which usually is caused by head trauma in a prematurely born baby during a difficult birth or which is caused by a fall in an elderly person or head trauma in a person who is on blood thinners. What is happening is that one of the blood vessels breaks and leaks blood, which accumulates between the "dura", a tough membrane that coats the skull and the skull itself.
Symptoms:
As this takes up space there is pressure on the adjacent healthy brain tissue and this causes the headache and other symptoms such as dizziness, seizures, and a rapidly enlarging head in prematurely born infants.
Diagnostic tests:
This consists of ultrasonic investigations, possibly CT and MRI scans and blood tests to check the status of blood thinning.
Treatment:
In newborns the pediatrician usually takes off a small portion of blood every day through puncture wounds to relieve the pressure onto the brain. If within two weeks this has not stopped the bleeding along with vitamin K treatment, a neurosurgeon would be consulted who can insert a subdural shunt.
In an old person where a fall in a nursing home is often the cause for the subdural hematoma, neurosurgical drainage often can brighten up the confusion, mental deterioration, headaches and dementia like clinical presentation. When there is a blockage of the fluid drainage system inside the brain, called ventricular system, the condition hydrocephalus develops, which requires shunt surgery. Here is a link to a site, which shows an image of a shunt (use the back arrow in the left upper corner of your screen to return to this page).
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References:
1. Goldman: Cecil Textbook of Medicine, 21st ed.,2000, W. B. Saunders Company
2. B. Sears: "The top 100 zone foods". Regan Books, Harper Collins, 2001.
3. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 176.
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8. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
9. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
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