What causes CSDH?
Small veins called “bridging veins” run between the dura and the surface of the brain. A subdural haematoma develops when these veins tear and leak blood, usually as the result of a head injury. A collection of blood forms over the surface of the brain. Membranes develop around the blood clot which slowly liquefies. Repeated small bleeds from the membranes cause it to grow in size after several weeks. As a result, the problem is usually not discovered immediately. Its presence becomes known only weeks after the initial injury. The chronic subdural haematoma can develop on one or both sides of the brain.
Who are at risk?
They are common in the elderly and chronic alcoholic because presence of brain shrinkage results in more brain movement when the head is accidentally hit even during a minor head injury. The bridging veins are stretched more and are more liable to be injured. Rarely, a subdural haematoma can occur spontaneously without there being an accident or injury.
People with chronic use of aspirin or anti-coagulant (blood thinning) medications, or diseases associated with blood clotting problems are at risk for developing CSDH.
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