Can young adults get a chronic subdural hematoma from head trauma?
“It’s possible but not likely,” says neurosurgeon Charles Park, MD, Director of The Minimally Invasive Brain and Spine Center at Mercy Medical Center in Baltimore. “Chronic subdural hematoma is usually for older people who have a lot of brain atrophy,” he adds.
This article refers strictly to chronic subdural hematoma that results from some kind of trauma, as opposed to a spontaneous bleed – which has actually been documented in medical literature to occur in young people, but it’s rare.
In general, brains shrink with age: age-related atrophy. This means more space between the brain and the skull.
It doesn’t take much trauma to tear the blood vessels in an elderly person’s brain.
If the tear is very small, blood will begin leaking, but at a very slow rate.
The space between the atrophied brain and the skull allows this blood to collect, and it can take two, even three, months for symptoms to begin first appearing.
The space allows the blood (and cerebrospinal fluid) to collect, and the symptoms of this chronic subdural hematoma may be a severe headache, altered mentation, weakness, paralysis and other symptoms that mimic that of a stroke.
In a young person, the same force of trauma to the head, that caused the chronic subdural hematoma in an elderly person, may tear the blood vessels, but due to a bigger brain (no age-related atrophy), there’s very little space, or to put it another way, there’s very tight space, between the brain and the skull.
Any bleeding will not build up and collect; it will just be reabsorbed by the body: no symptoms, no problem.
The same trauma may also not even tear the younger, stronger blood vessels.
Do not confuse chronic subdural hematoma with acute subdural hematoma.
In a young person — even a strong, very fit one — significant head trauma can result in an acute SDH – which is a life-threatening situation due to the rapid bleeding in the brain.