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Subdural haematoma
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The different types of subdural haematomas
Acute subdural - onset of symptoms usually within 48 hours after injury.
Chronic subdural – symptoms can occur between 2 weeks and several months after the initial injury. They are most common in elderly people, this is because the brain shrinks as we get older, causing greater free space between it and the skull, therefore, it takes longer for the blood clot to squash the brain and cause any symptoms. Because of the time lapse between the initial trauma and the onset of symptoms there may be a delay in diagnosis and it can often be difficult to relate it to an incident which may have happened several weeks previously. The development of a subdural haematoma in older people can also be related to the use of anti-coagulant medication such as warfarin. If the clotting function of the blood is unstable it can prevent a bleed from clotting and thus cause a large clot to form.
Extra dural haematoma - This term refers to bleeding between the inner skull and the dura mater (the outermost layer of the three layers covering the brain). The cause is usually head trauma, sufficient to tear blood vessels directly beneath the skull. Symptoms are often more immediate after the trauma and the deterioration rapid. Extra dural haematoma’s are more common in younger people, especially young men, this is because young men tend to partake in more high risk activities than women.
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