Subdural Hematoma: Why Your Brain Is Bleeding & Medically Approved Next Steps

A subdural hematoma is a serious medical condition that happens when blood collects between your brain and the tough outer covering of the brain called the dura. This bleeding usually happens after a head injury, but in some cases it can develop more slowly and with little warning.

Understanding what a subdural hematoma is, why it happens, and what to do next can help you act quickly and protect your brain health.

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What Is a Subdural Hematoma?

Your brain sits inside your skull, cushioned by layers of protective tissue and fluid. A subdural hematoma occurs when blood leaks from torn veins between the brain and the dura mater (the outermost protective layer).

As blood collects, it creates pressure on the brain. Because the skull is rigid, even a small amount of extra blood can increase pressure and interfere with normal brain function.

There are three main types:

• Acute subdural hematoma – Develops quickly, usually within minutes to hours after a serious head injury. This is a medical emergency.
• Subacute subdural hematoma – Symptoms appear days to weeks after injury.
• Chronic subdural hematoma – Develops slowly, sometimes weeks or months after a minor head injury. More common in older adults.

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Why Does a Subdural Hematoma Happen?

Most subdural hematomas are caused by head trauma. Even what seems like a mild bump can sometimes cause bleeding, especially in certain people.

Common Causes

• Falls (especially in older adults)
• Car accidents
• Sports injuries
• Assault or physical trauma
• Shaken baby syndrome (in infants)

Risk Factors

You may be at higher risk if you:

• Are over age 65
• Take blood thinners (like warfarin, apixaban, or aspirin)
• Have a bleeding disorder
• Drink alcohol heavily
• Have a history of repeated falls
• Have brain shrinkage related to aging

In older adults, the brain naturally shrinks slightly over time. This stretches the veins, making them more likely to tear—even after minor trauma.

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Symptoms of a Subdural Hematoma

Symptoms depend on how quickly the bleeding occurs and how much pressure builds in the skull.

Symptoms of Acute Subdural Hematoma

These can appear rapidly and may include:

• Severe headache
• Confusion or disorientation
• Drowsiness or difficulty staying awake
• Nausea and vomiting
• Slurred speech
• Weakness on one side of the body
• Seizures
• Loss of consciousness

An acute subdural hematoma is life-threatening and requires immediate emergency care.

Symptoms of Chronic Subdural Hematoma

These symptoms may develop gradually:

• Persistent headache
• Memory problems
• Personality changes
• Trouble walking or balance problems
• Mild weakness
• Increased confusion (sometimes mistaken for dementia)

Because symptoms can be subtle, chronic subdural hematomas are sometimes missed at first.

If you've recently experienced head trauma and are noticing any concerning symptoms, you can use a free AI-powered Acute Subdural Hematoma symptom checker to better understand your risk. However, this does not replace emergency medical care.

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How Is a Subdural Hematoma Diagnosed?

If a subdural hematoma is suspected, a doctor will:

1. Perform a neurological exam
2. Ask about recent head injuries
3. Order brain imaging

Imaging Tests

• CT scan – The most common and fastest way to diagnose a subdural hematoma.
• MRI – Sometimes used for more detailed imaging, especially in chronic cases.

These tests show the location and size of the blood collection and help guide treatment decisions.

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Medically Approved Next Steps

Treatment depends on:

• The size of the hematoma
• How fast it developed
• Your symptoms
• Your overall health

1. Emergency Care (For Acute Cases)

If the subdural hematoma is large or causing significant symptoms:

• Immediate hospitalization
• Monitoring in an intensive care unit (ICU)
• Possible emergency surgery

Surgical Options

• Burr hole drainage – Small holes drilled in the skull to drain blood.
• Craniotomy – A larger section of skull temporarily removed to access and remove the clot.

These procedures relieve pressure on the brain and can be lifesaving.

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2. Observation (For Small or Chronic Cases)

If the hematoma is small and symptoms are mild:

• Close monitoring with repeat CT scans
• Regular neurological exams
• Adjustment of blood-thinning medications

Sometimes chronic subdural hematomas resolve on their own, but many still require minor surgical drainage.

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3. Medication Management

Doctors may:

• Reverse blood thinners if safe
• Prescribe anti-seizure medication
• Manage blood pressure
• Provide pain control

Never stop blood-thinning medication without medical supervision.

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What Is the Recovery Like?

Recovery varies widely.

Factors That Affect Recovery

• Age
• Size of the bleed
• Speed of treatment
• Other medical conditions
• Level of consciousness at diagnosis

Some people recover fully, especially with prompt treatment. Others may experience long-term neurological issues.

Rehabilitation may include:

• Physical therapy
• Occupational therapy
• Speech therapy
• Cognitive rehabilitation

The earlier a subdural hematoma is treated, the better the chances of recovery.

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When Should You Seek Immediate Medical Attention?

Call emergency services or go to the nearest emergency room if you or someone else has:

• A head injury followed by confusion
• Sudden severe headache
• Weakness or numbness
• Repeated vomiting
• Seizures
• Loss of consciousness
• Increasing drowsiness

Do not "wait and see" if symptoms are worsening.

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Preventing Subdural Hematoma

While not all cases are preventable, you can lower your risk:

• Wear a seatbelt
• Use helmets for biking and contact sports
• Reduce fall risks at home (remove loose rugs, install handrails)
• Limit alcohol intake
• Review blood thinner use regularly with your doctor

Older adults should discuss fall prevention strategies during routine medical visits.

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The Bottom Line

A subdural hematoma is bleeding between the brain and its outer covering that increases pressure inside the skull. It is most often caused by head trauma and can range from mild to life-threatening.

Key points to remember:

• Acute subdural hematoma is a medical emergency.
• Symptoms may appear immediately or develop slowly over weeks.
• CT scans are the primary diagnostic tool.
• Treatment ranges from monitoring to emergency surgery.
• Early medical care improves outcomes.

If you're experiencing symptoms after a head injury and want to assess your condition before seeking care, try this free Acute Subdural Hematoma symptom checker for personalized guidance.

However, any signs of serious neurological symptoms require immediate medical attention. Speak to a doctor right away about anything that could be life-threatening or serious. When it comes to brain bleeding, prompt action can make a critical difference.

Your brain is too important to ignore warning signs.