Is it possible for exercise to prevent an elderly person from ever getting a chronic subdural hematoma?
“As we get older our brains shrink,” says Dr. David Beatty, MD, a retired general practitioner with 30+ years of experience and an instructor of general medicine for 20 years.
“This happens to everyone, but happens quicker in some people than others.
“When the brain becomes smaller this leaves more space between the brain and the bones of the skull.
“This leads to stretching of the bridging veins and greater movement of the brain within the skull vault.
“To give an analogy. Think of a poorly packed box in the trunk of your car. The contents will rattle around more and be more likely to get damaged than if they were well-packed.
“Cerebral atrophy is not thought to be a reversible process, so it is crucial to prevent it where possible and to minimize its progression.”
Risk factors for chronic subdural hematoma include brain shrinkage (atrophy), old age, getting bumped in the head and daily use of blood thinners.
But one need not get bumped in the head, or be on blood thinners, to suffer a spontaneous chronic subdural hematoma.
The aging brain has a tendency to shrink, and so does the brain in people who never exercise.
An atrophied brain creates more space between the brain and the skull, which provides more room for a chronic subdural hematoma’s fluid to take up space – and hence create symptoms which require surgery to remedy.
To keep the brain healthy, Dr. Beatty recommends healthy lifestyle choices to reduce the risk of ailments that lead to brain atrophy.
These include avoiding smoking, minimizing alcohol intake, avoiding high blood pressure, and taking measures to prevent or remedy obesity.
“Exercise is another weapon in the fight to prevent cerebral atrophy,” says Dr. Beatty.
“It’s been shown that exercise increases blood circulation to the brain and slows the rate of cerebral atrophy.
“I think exercise may well have another benefit with regard to subdural hematoma prevention.
“Someone who is physically fitter is less likely to have the falls that cause the head injury which causes the subdural.”
Exercise and Brain Shrinkage
It’s been well-established that exercise prevents brain shrinkage in animal studies, and even human studies have demonstrated this.
There is a study that shows that moderate exercise over one year can increase the size of the hippocampus of the brain in older people.
This study, however, didn’t look at chronic subdural hematoma; it looked at spatial memory.
But the fact remains that exercise increased brain size, albeit only a particular portion of the brain.
The hippocampus study was carried out by researchers at the University of Illinois, University of Pittsburgh, Ohio State University and Rice University, and focused on older people who already had hippocampus shrinkage (atrophy).
The hippocampus is responsible for memory.
The study involved 120 inactive older subjects who did not have dementia.
They were placed in two groups: One group walked for exercise (40 minutes daily, 3x/week), and the other group simply did toning and stretching exercises.
Prior to the study, MRIs were taken of the subjects’ brains. MRIs were then taken six months into the study, and at the end of one year.
The group who exercised had a volume increase of the right and left hippocampus.
And get this: In the second group, the hippocampus decreased in volume! I.e., lack of exercise = brain shrinkage.
Another study showed that exercise increases the number of small blood vessels in the brain. (Radiological Society of North America [Dec. 2, 2008]; “Exercise Helps Prevent Age-related Brain Changes In Older Adults”)
If a brain has more small blood vessels, perhaps this can have a protective effect against a slow brain bleed, though there have been no studies specifically investigating this.
The bottom line, though, is that exercise is crucial for optimal brain function and integrity, and these benefits will extend into old age.
Dr. Beatty has worked in primary medicine, surgery, accident and emergency, OBGYN, pediatrics and chronic disease management. He is the Doctor of Medicine for 
