What are risk factors for subdural hematoma (SDH)?

Updated: Jul 26, 2018
  • Author: Richard J Meagher, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Any degree or type of coagulopathy should heighten suspicion of subdural hematoma. Hemophiliacs can develop subdural hematoma after seemingly trivial head trauma. An aggressive approach to diagnosis and immediate correction of the factor deficiency to 100% activity is paramount.

Alcoholics are prone to thrombocytopenia, prolonged bleeding times, and blunt head trauma. Maintain a high level of suspicion in this population. Promptly obtain a computed tomography (CT) scan of the head when the degree of trauma is severe, focal neurologic signs are noted, or intoxication does not resolve as anticipated. In alcoholics, more than any other cohort, acute or chronic subdural hematomas can be due to the deadly combination of repetitive trauma and alcohol-associated coagulopathies.

Patients on anticoagulants can develop subdural hematoma with minimal trauma and warrant a lowered threshold for obtaining a head CT scan.


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