Subdural Hematoma and Cerebral Palsy

A subdural hematoma is a collection of blood located outside of the brain, typically after a traumatic head injury. After the injury, the blood collects between the tissues that layer and surround the brain. Although the blood collects outside of the brain, pressure on the brain begins to increase as the blood accumulates, resulting in disorders such as cerebral palsy (CP), and in severe cases, death.

Types of Subdural Hematomas

There are three types of subdural hematomas, categorized according to severity and development. All three types, although they differ in severity, must be treated as serious and require prompt medical attention:

  • Chronic: A chronic subdural hematoma is considered the least dangerous form of the disorder, and is marked by minor head injuries and slow bleeding. Symptoms usually take several weeks to appear.
  • Subacute: A subacute subdural hematoma is a bit more severe than chronic, but symptoms still take days, sometimes weeks, to appear.
  • Acute: An acute subdural hematoma is the most serious injury of all three types. It’s most often caused by an extremely severe head injury. Symptoms of an acute subdural hematoma almost always appear immediately.

Risk Factors for Subdural Hematomas

In addition to head injuries, other factors may contribute to the risk of developing a subdural hematoma, including:

  • Using an excessive amount of blood thinners while pregnant, such as aspirin or any other anticoagulant medicines.
  • Maternal alcohol abuse
  • Improper use of birthing tools during the delivery period of birth
  • Maternal infection and/or high blood pressure
  • Weakened blood vessels in the brain
  • Maternal pelvic inflammation

Symptoms of Subdural Hematoma in Infants

  • Difficulties with feedings
  • Shrill, high-pitched crying
  • Bulging from the infant’s soft spot on top of the head
  • Extreme lethargy and sleepiness
  • Seizures
  • Excessive vomiting
  • Sutures, the areas in the head where the skull bones join, may be separated
  • Unusual eye movement and inability to focus eyes
  • Any form of birth trauma

Treatment Options

It’s important to remember, as mentioned earlier, that any form of a subdural hematoma should be treated as an emergency and treatment should be sought as soon as possible. The most common types of treatments for severe subdural hematoma consists of emergency surgery in order to reduce pressure on the brain. In some instances, a craniotomy may need to be performed in order to remove large blood clots and hematoma.

After surgery and drainage, medication is usually given to help promote healing and treatment. For instance, if your child is prone to seizures, an anti-seizure medication, such as phenytoin, may be prescribed. For swelling reduction, corticoids and diuretics may be prescribed.

Prognosis

The prognosis of those affected by a subdural hematoma will depend upon what caused the injury, the severity, and where the injury is located on the head. Once the blood has been drained, people with chronic or subacute subdural hematomas have the best chances of healing. In most instances, however, rehabilitation will be needed before resuming daily activities.

For those with an acute subdural hematoma, the prognosis is more grim as unconsciousness and death are an unfortunate risk. Immediate treatment is absolutely necessary for anyone afflicted with an acute subdural hematoma.

Regardless of the type, people who’ve been affected by a subdural hematoma are at risk of having permanent seizures. A physician will usually prescribe medication to keep seizures under control.