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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5357
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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Is it possible for a chronic subdural hematoma to not

Customer Question

Is it possible for a chronic subdural hematoma to not present for 4 years? I had a concussion almost 4 years ago and was wondering if I could have an asymptomatic chronic subdural hematoma at this point? (I was on anticoagulants at the time I had the concussion, if that makes any difference?)Thanks.
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Bob replied 1 year ago.

Over the course of many months, a subdural hematoma typically stabilizes, organizes and liquifies, in a sense, to the point at which symptoms would on longer be expected to arise de novo. The only way a chronic subdural would become symptomatic after so many years would be if you rebled into the area damaged by the original hematoma. Being on an anticoagulant now would be a risk factor for this. The easiest way to find out the status of any suspected intracranial bleed, of course, is to get a CT scan. This would be particularly helpful in the setting of new neurological symptoms that have no other readily apparent explanation.

Customer: replied 1 year ago.
I'm not on anticoagulation anymore.
Expert:  Dr. Bob replied 1 year ago.

This reduces the chances of a rebleed, of course. Other risk factors include being on aspirin or longterm abuse of alcohol, certain medications, recurrent falls, or prior intracranial surgery. Otherwise, your risk would be about the same as the average 26 year old, which is to say very low.

Customer: replied 1 year ago.
You mean I have the same risk of developing bleeding symptoms as another 26 year old who has had no prior history of a head injury?
Customer: replied 1 year ago.
Or, stated more clearly, I have the same risk of developing a symptomatic subdural as any other 26 year old male who has had no prior history of head injury?
Expert:  Dr. Bob replied 1 year ago.

If you have no other risk factors such as those listed, you would have about the same risk as any other young person your age. Your prior head injury may increase your risk slightly, particularly if the subdural was large or there was damage to the adjacent brain. Some brain injuries do lead to shrinkage of brain tissue or replacement of brain tissue with fluid (encephalomalacia), which can put a person at increased risk if they suffer another head injury.

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