Spontaneous Subdural Hematoma Overview

Subdural hematoma is a collection of blood on the brain’s surface. These collections usually form after an acute injury, but they can be chronic or spontaneous (occurring without any cause). The prognosis of someone with this condition depends on the type of injury and its location. Getting treatment immediately can also improve a person’s outlook.

Risk Factors

While most subdural hematomas are the result of head injuries, a spontaneous subdural hematoma occurs without any obvious cause. Several risk factors increase the risk that someone will develop this condition. These factors include alcohol abuse, old age, repeated head injuries, use of blood thinner medications, and frequent falls.

Signs & Symptoms

This condition is a serious one, affecting speech, walking, and mental ability. Signs and symptoms include difficulty with balance, headache, confusion, loss of consciousness, lethargy, difficulty with walking, nausea, numbness, vomiting, slurred speech, seizures, weakness, and visual disturbances. If this condition occurs in an infant, the signs and symptoms are different. They include difficulty eating, high-pitched wailing, sleepiness/lethargy, increased circumference of the head, persistent vomiting, irritability, and bulging soft spots of the skull.


Diagnosis of a spontaneous subdural hematoma involves a thorough neurological exam to determine the cause of symptoms such as confusion and loss of consciousness. CT or MRI scanning are also used to determine if this condition is present.


This is a very serious condition that requires emergency treatment. Surgical procedures are used to relieve the building pressure in the brain. One procedure used requires the surgeon to drill a hole in the skull, which drains the blood and reduces pressure. Craniotomy may also be used to relieve the pressure of bleeding in the brain. This procedure involves a larger opening in the skull. Medications are also used in the treatment of this condition. Swelling is relieved with corticosteroids and diuretics, and anti-seizure medications are used to prevent seizures.


This condition can cause seizures, permanent speaking difficulties, permanent weakness and numbness, memory loss, headaches, and brain herniation. Brain herniation is when brain pressure increases so much that coma or death result. Seek immediate medical attention if any signs of subdural hemorrhage occur. Getting immediate help can make the difference between survival and death.


National Institutes of Health Medline Plus. "Subdural Hematoma."

eMedicine from WebMD: "Subdural Hematoma."