If your neurological symptoms like headache come and go, does this rule out a chronic subdural hematoma?

Let’s say you get hit in the head really hard but don’t experience any immediate neurological symptoms such as loss of consciousness, confusion or an immediate headache that worsens.

In fact, you feel fine other than the feeling that you just hit your head really hard.

You may even go to the ER to have a CT scan just in case there’s bleeding in your brain. Everything checks out normal and life goes on.

But you know all about chronic subdural hematoma—enough to worry you that in the next 90 days, there’s a possibility (especially if you’re over 65) that you’ll begin experiencing neurological symptoms due to slow bleeding in the brain over time (chronic) that was set in motion by the strike to your head weeks before.

You get a headache a week later and begin wondering, “Is this it?” But the headache never gets beyond a level 3 on a pain scale of zero to 10, and next day it’s gone.

You figure, If that was a chronic subdural hematoma, it would not have gone away.

Several days later you have another mild headache, and this time it lasts only that day.

A few days later another little headache occurs, and again, it’s temporary. (There are no other symptoms.)

And chances are pretty high that these minor headaches are not from any bleeding in your brain, but from the traumatized nerves outside of your skull, in your scalp, that took a good bang when you hit your head.

But still, you wonder:

Would the symptoms of a chronic subdural hematoma necessarily be ongoing and persistent rather than come and go?

After all, the bleeding doesn’t come and go. There’s either bleeding or there’s not.

If it’s there and causing symptoms…the symptoms will necessarily persist until the blood is surgically drained, right?

I asked Charles Park, MD, a neurological surgeon, if the symptoms of a chronic subdural hematoma can come and go.

He replied: “This is very true.” He is Director of The Minimally Invasive Brain and Spine Center at Mercy Medical Center in Baltimore.

Now realize that this article refers to chronic subdural hematoma, rather than the acute type (which is immediately life-threatening and can cause more dramatic symptoms such as projectile vomiting and stupor within hours, even minutes, of the trauma).

Dr. Park continues, “Once the cSDH develops, it will form a set of fibrous membranes to compartmentalize the cSDH.

“However, these membranes also have blood supply and it can bleed as well, adding to the cSDH already present.

“So, the symptoms can come and go as the size of subdural hematoma is gradually and incrementally increasing.”

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.  


Top image: Shutterstock/Dragana Gordic