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Treatments and drugs
By Mayo Clinic staffSome subdural hematomas don't need to be removed because they're small and produce no signs or symptoms. Diuretic medications may help control brain swelling (edema) after a head injury.
Surgery
However, hematoma treatment often requires surgery. The type of surgery depends on the characteristics of your hematoma. Options include:
- Surgical drainage. If the blood is localized and isn't clotting excessively, your doctor may create what's called a burr hole through your skull and then remove the liquid by suction.
- Craniotomy. Large hematomas may require that a section of your skull be opened (craniotomy) to remove the blood.
Recovery
After surgery, your doctor may prescribe anticonvulsant drugs, such as phenytoin (Dilantin), to control or prevent post-traumatic seizures. These medications are continued as long as a year after the trauma. Amnesia, attention difficulties, anxiety, sleep problems and headache may occur and continue for some time.
Recovery after an intracranial hematoma can be prolonged and may be incomplete. In adults, most recovery takes place within the first six months after the injury. Children usually recover faster and more completely than adults do.
- Traumatic brain injury: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/tbi/detail_tbi.htm. Accessed May 9, 2009.
- Traumatic brain injury. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec21/ch310/ch310a.html#S21_CH310_T001. Accessed May 11, 2009.
- Smith ML, et al. Neurosurgery. In: Brunicardi FC, et al. Schwartz's Principles of Surgery. 8th ed. New York, N.Y.: McGraw-Hill, Medical; 2005. http://www.accessmedicine.com/content.aspx?aID=820106. Accessed May 8, 2009.
- Facts about concussion and brain injury. U.S. Centers for Disease Control and Prevention. http://www.cdc.gov/ncipc/tbi/tbibook.pdf. Accessed May 8, 2009.
- Moulton RJ, et al. Head injury and intracranial hypertension. In: Hall JB, et al. Principles of Critical Care. 3rd ed. New York, N.Y.: McGraw-Hill, Medical; 2005. http://www.accessmedicine.com/content.aspx?aID=2297849. Accessed May 8, 2009.
- Ropper AH. Concussion and other head injuries. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2904523. Accessed May 12, 2009.
- Rordorf G. Spontaneous intracerebral hemorrhage: Pathogenesis, clinical features, and diagnosis. http://www.uptodate.com/index/home.html. Accessed May 12, 2009.
