A neurosurgeon says there is one distinguishing feature between a migraine headache and chronic subdural hematoma head pain.

Chances are, if you have a chronic subdural hematoma, you might remember in your recent history getting hit on the head or bumping your head hard on something.

But some patients with cSDH are unable to report the head trauma that caused it.

This is because sometimes, the “trauma” seemed insignificant at the time, such as a run-of-the-mill bonking the head on the car door frame when getting into the car. It’s noticed at the moment, but is quickly forgotten.

Five weeks later when the headache from the chronic subdural hematoma arises, the patient does not link it to the little mishap with the car door frame.

And all it takes is this seemingly minor trauma to induce a cSDH in an elderly person.

But a person over age 60 may also have migraines, and people younger than 60 can get a chronic subdural hematoma.

“One distinguishing feature is that the headache from cSDH is worse in the mornings,” says

Charles Park, MD, Director of The Minimally Invasive Brain and Spine Center at Mercy Medical Center in Baltimore.

He is a neurosurgeon and continues, “Migraine headaches are severe, and associated with light, sound, etc., and usually unilateral.” That means one-sided.

“At night, when we lay flat, there is an increase in venous blood return to the heart and increase in venous pressure. so, the soft structures, such as discs and nerves and brain, get swollen or get larger, which causes a bit more pressure on the brain and this causes worsening headache.”

What about onset of migraine?

Is it always gradual? Or can it be sudden?

“Depends on the type of migraine headaches, but usually the onset of migraine headache is much faster than chronic subdural hematoma, which develops over days,” says Dr. Park.

There are exceptions to the rule of developing over days, however.

My mother was diagnosed with a cSDH six weeks after she fell and hit her head.

She awakened one morning with a horrible headache.

The day prior, going all the way back six weeks, she had not had any headaches.

Even when she got into bed the night prior, she felt perfectly fine.

Sometimes, the brain does not act in ways that we think it should.

Like that old saying goes, “If the human brain were simple enough for us to understand, we’d be too simple to understand it.”

Dr. Park specializes in minimally invasive surgical techniques for treatment of conditions affecting the brain and spine. He’s skilled in advanced procedures and techniques that utilize innovative computer technology and image-guided surgery systems.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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