Chronic Subdural Hematoma in North Carolina

What is Chronic Subdural Hematoma?

A chronic subdural hematoma refers to an accumulation of aged blood and its breakdown products located between the brain’s surface and the outermost protective covering known as the dura mater. This chronic phase typically emerges several weeks after the initial bleeding event.

Causes of Chronic Subdural Hematoma

A subdural hematoma takes shape when tiny blood vessels, referred to as bridging veins, become damaged and release blood. These veins are responsible for connecting the dura to the brain’s surface and are usually affected by head injuries. The blood accumulates over the brain’s surface. In cases of chronic subdural hematoma, blood either slowly seeps from these veins over time or a rapid hemorrhage resolves on its own.

Chronic subdural hematomas are more frequently observed in older adults due to the natural shrinkage of the brain that occurs with aging. This shrinkage places stress on and weakens the bridging veins, making them more susceptible to rupture in older individuals, even following minor head trauma. It is not uncommon for patients or their families to have no recollection of any injury leading to a subdural hematoma.

Several factors increase the risk of developing chronic subdural hematoma, including:

  • Long-term heavy alcohol consumption
  • Prolonged usage of medications like aspirin, nonsteroidal anti-inflammatory drugs (e.g., ibuprofen), or anticoagulant drugs such as warfarin
  • Medical conditions that impair blood clotting
  • Prior head injury
  • Advanced age

Recognizing the Symptoms

While some individuals with chronic subdural hematomas may remain asymptomatic, the size and location of the hematoma can lead to various symptoms such as:

  • Confusion or coma
  • Memory impairment
  • Speech and swallowing difficulties
  • Gait disturbances
  • Drowsiness
  • Headaches
  • Seizures
  • Weakness or numbness in the face, arms, or legs

A thorough medical history will be obtained by your healthcare provider, followed by a comprehensive physical examination. The examination will focus on evaluating brain and nervous system function, assessing factors like balance, coordination, mental acuity, sensory perception, strength, and walking abilities. If a hematoma is suspected, diagnostic imaging tests such as CT or MRI scans will be conducted.

Treatment Options

The primary objective of treatment for chronic subdural hematoma is symptom management and the prevention of permanent brain damage. Medications may be prescribed to control or prevent seizures.

In some cases, surgery may be necessary. Surgical interventions can involve drilling small holes in the skull to relieve pressure and facilitate the drainage of blood and fluids. For larger hematomas or solid blood clots, a more extensive procedure known as craniotomy, involving a larger skull opening, may be required for removal.

Hematomas that do not cause symptoms may not warrant treatment, as chronic subdural hematomas often reoccur after drainage. In such instances, it may be preferable to leave them untreated unless they produce noticeable symptoms.

Schedule a Consultation

The care team at Neurosciences & Spine Center can help you decide on the treatment that's best for you. They specialize in minimally invasive surgery and are experienced in diagnosing and treating disorders and diseases, using the newest techniques for relieving pain and returning you to an active lifestyle. To make an appointment at Neurosciences & Spine Center call 919-784-7550.

Patient Testimonials

Nat Lambeth
I am a former patient of Dr Koolevelt, hate he retired am of the opinion he is a great doctor. I had a very good result from my surgery last April. I have encountered a new problem. I called and got an appoint ment to see Daniel Ingram he to is great. He listen to my complaint(s), then examined me. He sent me for xrays, and gave me a recomended treatment plan. Within hours of having my xrays he called me back with the preliminary results. He said he would get me seen for an injection to rule out possible other issues. He is a warm friendly professional. Great bedside manner. You don't find medical professionals of his quality in every practice. UNCRex Neuroscience is lucky to have him.
Dennis Hlad
Everyone was pleasant & efficient. Daniel Ingram, PA went over the previous MRI showing me where the problem is. Then we discussed the options. He suggested if the symptoms changed to contact him.
Jill Schade
I have known Dr Koeleveld and his team over 19 years and due to the nature of my back history L5/S1. There is NO one else I would trust but Dr K, Dan, Judy and his wonderful team. I should have written this sooner as I am 2 years post fusion and doing wonderful. Their expertise, care and compassion is second to none.
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Amazing. Mom needed nerve ablation on the back. She has a pacemaker and these folks were wonderful.
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Best experience I had even Surgery went great, Dr.Lacin knew exactly what needed to be done.
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When I had stenosis quite a while ago, he performed surgery,and I woke up with no pain. What an extreme relief.
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Great job Dr. Buttram!
Whitney Moore
John A. Engler, MD was amazing! I've been having back pain for years (had surgery in 2011) and was good for awhile. However I started going to a pain management clinic 3 years ago when it started up again. After an incident that cause me to go the the ER I was referred to Dr. Engler. He was extremely nice and informative. He took the time to explain everything to me. Extremely satisfied with the care I received will update after everything is said and done.
Mary Roby
I am now pain free and well on my way to a full recovery thanks to Dr. Lacin. Both he and his staff are knowledgeable, compassionate, caring and professional. Dr. Lacin performed back surgery on me as well as my mom and we will both be forever grateful.
Jeff Wiblitzhouser
Dr. Lacin's skill and dedication gave me a new lease on life. As a designer and builder of custom homes and remodels, I depend on my ability to get in and out of houses, tight spaces, etc., and my back had gotten to the point where the pain was intolerable. I didn't hire Dr. Lacin to tell me what I wanted to hear, I hired him to help me regain functionality. Thank You Dr. Lacin and your staff!!
Joann
My primary care doctor referred me to Dr Engler for a second opinion. First, I would like to say I would highly recommend seeing Dr Engler. He was patient, very thorough, and really took the time listening to me when I explained the pain I been experiencing. I was so relieved when he immediately pinpointed the cause of my pain. Dr Engler not only told me my options, but he explained them in-dept to me, and answered all my questions. I was truly satisfied with my visit. I Couldn't have asked for a better doctor.
Sharon Greene
Superb care from Dr Lacin and staff. Dr Lacin repaired my cervical disc, and with each visit I felt as if my care was most important to him and he Treated me like I was his only patient. Great bedside manner and Excellent surgeon. Highly recommended!!!
Brooke Weisner
Dr. Buttram was amazing, he helped me recover from a severely herniated disc, which ultimately had to have surgery on. his staff is super sweet and friendly, I would recommend him to anyone who is having back pain.