Subdural hematoma symptoms
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Symptoms of Subdural Hematoma: A Comprehensive Overview
Introduction to Subdural Hematoma Symptoms
Subdural hematoma (SDH) is a condition characterized by the accumulation of blood between the dura mater and the brain. This condition can be acute or chronic, with chronic subdural hematoma (cSDH) being more prevalent in older adults. The symptoms of SDH can vary widely, often mimicking other neurological conditions, which can complicate diagnosis and treatment.
Common Symptoms of Chronic Subdural Hematoma
Headaches and Cognitive Changes
Headaches are the most frequently reported symptom of chronic subdural hematoma, often described as persistent and worsening over time . Cognitive changes, including memory problems and confusion, are also common, affecting a significant portion of patients . These cognitive deficits can range from mild confusion to severe cognitive impairment, with studies indicating that up to 61% of patients exhibit cognitive impairment before treatment, which improves significantly post-surgery.
Motor and Sensory Symptoms
Patients with cSDH often present with motor and sensory disturbances. Weakness, particularly hemiparesis (weakness on one side of the body), is a notable symptom . Other motor symptoms include gait disturbances and balance problems, which can significantly impact daily functioning . Sensory changes, although less common, can also occur, contributing to the overall clinical picture.
Behavioral and Neuropsychiatric Symptoms
Behavioral and neuropsychiatric changes are also associated with cSDH. These can include irritability, changes in personality, and other neuropsychiatric symptoms. In some cases, these symptoms can be severe enough to mimic other conditions such as dementia or psychiatric disorders, complicating the diagnostic process.
Parkinsonism Symptoms
A rare but notable symptom of cSDH is secondary parkinsonism, which includes rigidity, bradykinesia (slowness of movement), and tremors. These symptoms are thought to result from the mechanical compression of the basal ganglia by the hematoma. Surgical intervention often leads to significant improvement in these parkinsonism symptoms.
Other Symptoms
Other symptoms of cSDH can include nausea, vomiting, and changes in mental status, ranging from mild confusion to coma in severe cases. In infants, symptoms can include head enlargement, vomiting, irritability, and convulsions.
Conclusion
Chronic subdural hematoma presents with a wide array of symptoms, making it a complex condition to diagnose and treat. Common symptoms include persistent headaches, cognitive and behavioral changes, motor and sensory disturbances, and, in rare cases, parkinsonism. Early diagnosis and appropriate treatment, often surgical, are crucial for improving outcomes and reducing the risk of long-term complications. Understanding the diverse symptomatology of cSDH is essential for clinicians to provide timely and effective care.
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