The diagnosis of a chronic subdural hematoma in the emergency room is easy to make: A CT scan easily reveals the collection of blood. But what happens once this diagnosis is made?
My mother went into the ER with alarming symptoms and was ultimately diagnosed with a chronic subdural hematoma.
You may have heard of the words, “subdural hematoma,” and think that this is always an emergency situation that can kill in minutes.
However, there are three kinds of subdural hematoma, says MedlinePlus: acute, subacute and chronic.
Symptoms can occur immediately after a head trauma, or not show up for a few months after the head trauma.
In my mother’s case, the symptoms began appearing six weeks after she fell and hit her head.
In the ER, the doctor suspected a stroke (she had lower body weakness, more so with the left leg, and a bad headache) and didn’t even mention chronic subdural hematoma. A CAT scan with contrast dye was ordered.
Meanwhile the ER doctor gave my mother a neurological exam which included things like asking her to lift her legs against the doctor’s hand resistance.
The CAT scan revealed the chronic subdural hematoma (blood in the brain leaking from torn veins).
In my mother’s case (I am not speaking for ANY or ALL cases of chronic subdural hematoma), she was admitted to the neurology unit of the hospital, and told that she would have surgery the following morning to drain the blood.
I asked why was there a delay; won’t it get really worse overnight? The doctor said that if it were an emergency, they would not wait till next morning to operate.
It was not an emergency and it was not expected that the situation would deteriorate overnight. The doctor believed that my mother’s condition was stable, and told me throughout the night she’d get neurological checks by the nurses.
This was the first time I’d ever learned of the “chronic” type of subdural hematoma.
I’d always believed that if symptoms of a hematoma began weeks after the head trauma, that the situation was just as potentially fatal as when the symptoms occur rapidly right after the head trauma.
The idea of a very gradual, slow leakage of blood had never occurred to me, probably because I first learned of “subdural hematoma” after watching a clip of a boxer receiving the “fatal blow” in a professional match, knocking him out cold.
This had fascinated me because the boxer wasn’t just unconscious, but his body was rigid (“posturing”) as the medics cumbersomely hoisted him (though he was extremely thin) onto the stretcher. This stuck in my mind.
However, when the ER doctor said my mother had a “chronic” subdural hematoma, I instantly realized that this was a less serious form, not to be compared to the one that the boxer had suffered.
A neurosurgeon was contacted and the surgery was tentatively for next morning. The ER doctor was not able to give fine details other than explaining that the procedure involved drilling a hole in the head and draining the fluid.
Though this sounds invasive, the surgery is actually non-invasive and minor. The ER doctor said it was a 10-minute procedure.
My mother was transferred to the neurology wing and set up in her room. Next afternoon she had the surgery which involved general anesthesia, but the neurosurgeon indeed said it would take about 15 minutes and he didn’t seem the least bit worried, as though this was not much more than wrapping a sprained ankle.
