Vascular · Head Injury
Subdural Haematoma Treatment in Faridabad
When an elderly parent becomes slowly confused or unsteady weeks after a minor fall, a subdural haematoma may be the reason, and it is often very treatable.
सबड्यूरल हिमेटोमा दिमाग़ और उसकी झिल्ली के बीच जमा खून है। बुज़ुर्गों में, ख़ासकर खून पतला करने की दवा लेने वालों में, यह मामूली चोट के हफ़्तों बाद भी बन सकता है। छोटे मामलों में निगरानी और बड़े मामलों में बर-होल सर्जरी की जाती है।
Understanding Subdural Haematoma
A subdural haematoma (SDH) is a collection of blood between the brain's surface and its tough outer covering, the dura. It forms when small bridging veins crossing this space tear. An acute SDH usually follows a significant head injury, appears within hours and is often an emergency. A chronic SDH builds up over weeks, after a knock so minor that nobody remembers it.
Chronic SDH is especially common in older people. As the brain naturally shrinks with age, these veins stretch and tear more easily, and blood thinners such as aspirin, clopidogrel, warfarin or newer anticoagulants add to the risk. Families in Faridabad often first notice a parent becoming forgetful, sleepy, unsteady or weak on one side, and put it down to age.
Many chronic subdural haematomas respond well to treatment. Small ones may simply be watched, while larger ones are commonly drained through one or two small burr holes. Care of head-injury and critical neurological patients is a listed area for Dr. Naresh Panwar at Sarvodaya Hospital, Sector 8, which serves families from NIT, Ballabhgarh and Greater Faridabad.
Common symptoms
Symptoms vary from person to person. Having one of these does not mean you have this condition.
Persistent or worsening headache days or weeks after even a minor bump.
New forgetfulness or muddled thinking, sometimes mistaken for dementia.
Sleeping more than usual or being hard to wake.
Dragging a leg or dropping things from one hand.
New falls or a shuffling gait.
Possible causes & risk factors
Natural brain shrinkage stretches the bridging veins.
Antiplatelet and anticoagulant medicines make bleeding more likely and larger.
Even small bumps can tear veins in older people.
Increases falls and brain shrinkage.
Road accidents and falls from height cause acute SDH at any age.
When to seek help
Book a routine consultation
- Mild headache weeks after a minor fall, especially in someone on blood thinners
- Gradual change in memory, walking or behaviour in an older relative
- A small SDH on a scan, for advice on watching versus drainage
- Decisions about stopping or restarting blood thinners
Seek emergency care
- Increasing drowsiness, confusion or difficulty waking
- New or worsening weakness, or a seizure
- Repeated vomiting or severe headache after any head injury: go to the nearest emergency department or call 112
How it is diagnosed
The main test; shows the size, age and pressure effect of the collection.
Helpful when CT is unclear or for small, older collections.
Guide whether blood-thinner effects need reversing.
Alertness, strength and speech are tracked to guide decisions.
Available treatment options
Treatment is chosen after examining you and studying your scans. Many people do well without an operation.
Small chronic SDHs with mild or no symptoms may be watched; many shrink gradually.
Blood thinners are reviewed with the cardiologist or physician, balancing bleeding risk against heart or stroke risk.
One or two small holes are made in the skull, the liquid blood is washed out, and a soft drain is often left briefly.
Needed for acute SDH with thick clotted blood, or chronic collections with tough membranes.
For severe acute SDH with major brain swelling, a piece of bone may be left out temporarily.
When neurosurgery may be recommended
- The collection is thick enough to press on the brain or shift the midline
- Symptoms such as weakness, confusion or drowsiness
- Growth on repeat scans
- Acute SDH with falling consciousness after injury
Procedure overview
A simplified outline. The exact steps depend on your scans and the approach chosen.
- PreparationBlood thinners are reversed or paused as safely as possible.
- AnaesthesiaGeneral anaesthesia, or in selected patients local anaesthesia with sedation.
- Burr holes and washoutSmall holes are made over the collection and the old liquefied blood is rinsed out.
- Drain and mobilisationA drain may stay for a short period, after which the patient is helped to sit and walk.
Potential benefits, risks & limitations
Potential benefits
- Confusion, weakness and headache often improve, sometimes within days
- Small incisions and a relatively short operation
- Can relieve life-threatening pressure in acute cases
Possible risks
- Recurrence needing another procedure
- Seizures
- Infection
- Fresh bleeding
- Chest infection or confusion in elderly patients after surgery
Draining the blood does not reverse age-related brain changes or other illnesses, so some older patients recover slowly. Acute SDH after severe injury may leave lasting effects despite timely surgery.
Recovery & follow-up
After burr-hole drainage, many older patients become more alert within a few days, though the pace varies. Early walking with support and good hydration help, and a repeat CT is usually planned to check the collection has not returned.
Restarting blood thinners is a shared decision between your neurosurgeon and the prescribing doctor. At home, remove loose rugs, add night lights and grab bars, and seek help early if symptoms return. See when a head injury needs emergency care.
Why consult Dr. Naresh Panwar
- Listed experience in management of critical neurological and head-injury patients
- Member of the Neurotrauma Society of India (NTSI)
- Senior Consultant & Head Unit (II) – Neurosurgery, Sarvodaya Hospital, Sector 8, Faridabad
- Previously Consultant, Neurosurgery at Asian Institute of Medical Sciences, Faridabad
Questions to ask your surgeon
Write these down and bring them to your appointment.
- Is this an acute or a chronic haematoma?
- Can it be watched, or does it need draining now?
- Should blood thinners be stopped, and for how long?
- What is the chance it comes back?
- What can we change at home to prevent falls?
Frequently asked questions
My father fell a month ago and now seems confused. Could it be related?
It could. Chronic subdural haematoma often appears weeks after a minor fall, especially in older people or those on blood thinners. A head CT can check this quickly, so do not assume it is just ageing.
What is burr-hole surgery?
One or two small holes are made in the skull to drain liquefied blood from a chronic subdural haematoma. It is a relatively short operation, and in selected patients may be done under local anaesthesia with sedation.
Dimag mein khoon jamne ka operation zaroori hai kya?
Har case mein nahi. Chhota thakka jisse lakshan na hon, kai baar CT scan se monitor kiya jaata hai. Agar thakka bada ho, dabaav ho ya lakshan badh rahe hon, tab operation ki salaah di jaati hai.
Can the haematoma come back after drainage?
Yes, some chronic SDHs recur, more often in older patients and those on blood thinners. Follow-up scans and watching for returning symptoms matter, and a recurrence is usually treatable.
We live in NIT Faridabad. How soon should an elderly person have a CT after a fall?
With headache, vomiting, drowsiness, confusion or weakness, go to an emergency department immediately or call 112. With milder symptoms, especially on blood thinners, arrange a same-day doctor review. For consultations at Sarvodaya Hospital, Sector 8, call +91 96608 88640.
Related care & reading
Appointments
Your brain and spine health deserve a carefully considered plan.
Request a consultation with Dr. Naresh Panwar at Sarvodaya Hospital, Sector 8, Faridabad. Bring your MRI or CT scans and reports, and the care team will help you prepare.