Subdural Haematoma — Emergency Neurosurgery in Noida

Chronic SDH usually results from tearing of small bridging veins between the brain surface and the dura after a minor or even forgotten head injury. Blood accumulates slowly over 2–6 weeks. Risk factors include: age over 65 (brain atrophy creates more space for blood to accumulate), anticoagulant therapy (warfarin, aspirin, novel anticoagulants), excessive alcohol intake, and recurrent falls.

Small, thin, asymptomatic chronic SDHs in a stable patient may be managed conservatively with serial MRI monitoring, stopping anticoagulants if safe, and dexamethasone to reduce haematoma size. Surgery is required when the haematoma is large (>10 mm), causing midline shift, or producing neurological symptoms. In symptomatic chronic SDH, burr hole drainage produces rapid and dramatic neurological improvement.

Recently certain recurrent CSDH or high risk patients can be managed through endovascular treatment with MMA embolization. 

We have a dedicated team of endovascular neurosurgeons at Medanta Hospital, Sector 50, Noida specifically to treat these type of cases.

Acute SDH with neurological deterioration is a neurosurgical emergency requiring surgery within hours. Chronic SDH is usually urgent (surgery within 24–48 hours of presentation) rather than an immediate emergency, but should not be delayed. Medanta Hospital, Sector 50, Noida has 24×7 emergency neurosurgical capability. Contact emergency services or Team Sushrut at +91 98103 24401.

Most patients with chronic SDH make an excellent recovery after burr hole drainage. The dramatic improvement in consciousness, confusion, and weakness that often occurs within 24–48 hours of surgery can be remarkable — particularly in elderly patients who appeared very unwell pre-operatively. Recurrence (haematoma re-accumulation) occurs in 5–30% of cases and may require repeat drainage.