Subdural haematoma

What it is

Subdural hematoma is rupture of the bridging veins, with the blood collection between the dura and the arachnoid. It can be acute, from a traumatic high-energy impact, or chronic, associated with mild trauma, cerebral atrophy, old age and alcoholism.

Causes and risk

The predisposing factors are brain atrophy and trauma, and alcoholics and elderly are prone to it. The groups listed at risk are the elderly, infants and alcoholics, together with patients on anti-thrombotic therapies. It is also seen in shaken babies. One described case is a man with atrial fibrillation on warfarin who presents with an acute confusional state and no proceeding trauma or fall, which shows that the absence of a fall does not rule it out. Put in one line, the causes of subdural are minimal trauma in old age, child abuse, and anticoagulants or coagulopathy.