What are the signs and symptoms of acute subdural hematoma (SDH)?

Updated: Jul 26, 2018
  • Author: Richard J Meagher, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Acute traumatic subdural hematoma often results from falls, violence, or motor vehicle accidents. Suspect acute subdural hematoma whenever the patient has experienced moderately severe to severe blunt head trauma. The clinical presentation depends on the location of the lesion and the rate at which it develops. Often, patients are rendered comatose at the time of the injury. A subset of patients remain conscious; others deteriorate in a delayed fashion as the hematoma expands.

Patients found to have an acute subdural hematoma are usually older than other patients with trauma. In one study, the average age of a patient with trauma but without acute subdural hematoma was 26 years, while the average age of patients with an acute subdural hematoma was 41 years. Therefore, older patients appear to be at greater risk for developing an acute subdural hematoma after head injury. This is believed to stem from older patients having more brain atrophy, which allows more shear force against bridging veins immediately after impact.

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