Emergency Management of Subdural Hematoma

Abstract

Background: Subdural hematoma is extra-cerebral accumulation of blood between the dura matter and the subarachnoid layer. It is almost always caused by trauma or due to blood thinning therapies, and occurs due to rupture of bridging veins. Acute subdural hematoma is an emergency situation and requires prompt diagnosis using CT most of the time, and management requires surgery as well as reversal of anticoagulants. Materials and methods: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1985, through February 2017. The following search terms were used: subdural hematoma, emergency management of subdural hematoma, CT vs. MRI in diagnosis of subdural hematoma, treatment of subdural hematoma. Aim: In this review, we aim to study the etiology of subdural hematoma, explore how to diagnose and manage it in the emergency department Conclusion: Subdural hematoma is an important clinical presentation that needs proper and prompt surgical management and treatment. Treatment should be as less invasive as possible, with higher efficacy and lower recurrence rates. Non-surgical approaches are still being studied with no proven efficacy for them until now.