What Is a Subdural Hematoma?
硬膜下血肿是一种常见的神经系统疾病，发生在头部损伤后. 当血液在大脑最外层（硬脑膜）和大脑之间积聚时，就会发生脑出血.
大发娱乐的神经外科医生擅长传统手术技术和微创手术，如 middle meningeal artery (MMA) embolization. We use MMA embolization as an alternative to brain surgery for some patients. At University of Utah Health, 大发娱乐为大发娱乐的硬膜下血肿患者大发娱乐提供特殊的护理和支持的每一步.
Types of Subdural Hematomas
Acute Subdural Hematoma
Acute subdural hematomas usually occur because of a head injury. In cases that need immediate treatment, 患者将接受传统手术，切除一部分颅骨, the outermost covering of the brain (the dura) is opened, and the acute subdural hematoma is evacuated.
Most cases, however, do not require treatment. Instead, patients are admitted to the hospital, 一个多学科的护理团队将观察血肿，以确保它不会随着时间的推移而恶化，并确保患者能够重新站起来. 这种类型的硬膜下血肿通常会在几周内自行消失.
Chronic Subdural Hematoma
A chronic (non-acute) subdural hematoma is a commonly encountered problem, particularly in older adults. It often forms due to an acute subdural hematoma that will not go away. Instead of breaking down, 血液会形成膜和膜内的微小血管，吸引水和渗出物. 这导致血液膨胀并形成一种不能自行溶解的明胶状物质.
Subdural Hematoma Symptoms
The most common symptoms of acute and chronic subdural hematomas include:
- headache,
- confusion,
- changes in behavior,
- dizziness,
- nausea and vomiting,
- fatigue,
- weakness on one side of the body,
- difficulty with walking,
- disinterest in normal activities, and
- seizures.
这些症状可能在头部受伤后立即出现或随着时间的推移而发展. Some people will not experience any symptoms for several weeks. Frequently, in patients who have chronic (non-acute) subdural hematomas, they may not even remember experiencing a head injury in the past.
Diagnosing Acute & Chronic Subdural Hematomas
When doctors suspect that a patient may have a subdural hematoma, they use a computed tomography (CT) scan of the head to make a definite diagnosis. CT扫描结合了从不同角度拍摄的一系列x射线图像，并使用计算机软件创建骨骼和脑组织的横截面图像（切片）.
When a patient has a chronic (non-acute) subdural hematoma that requires treatment, our neurosurgeons frequently use magnetic resonance imaging (MRI) to help predict which treatment strategy will be most effective. 核磁共振成像使用强大的磁场和无线电波来生成脑组织的详细图像. MRI的使用使大发娱乐的神经外科医生能够推荐最可能导致硬膜下血肿长期治愈的治疗方法，并且在未来复发的可能性最低.
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Subdural Hematoma Treatment
患有急性硬膜下血肿的人通常不需要治疗，因为血肿会随着时间在体内分解. However, in some cases, following a head injury, 急性硬膜下血肿需要立即手术治疗，以减轻对大脑的压力.
慢性（非急性）硬膜下血肿的治疗方案包括：
- Medication—This may help resolve the subdural hematoma.
- Brain surgery (craniotomy)—这是一种打开颅骨去除硬膜下血肿的外科手术.
- Middle meningeal artery (MMA) embolization—其中包括将导管插入向硬膜下血肿供血的动脉并释放专门的小球来止血.
特别是慢性硬膜下血肿，可能是复杂的，并可能在手术后复发. 一些患者可能需要MMA栓塞、手术和药物联合治疗. 你的神经外科医生会讨论你的选择，并推荐一个个性化的治疗方案，以确保你的健康得到最好的结果.
Brain Surgery
大发娱乐可能需要用脑外科手术来治疗一些慢性硬脑膜下血肿，以排出在大脑和硬脑膜（大脑最外层）之间聚集的血液。.
For some patients, surgery may be performed under sedation in our Neurocritical Care Unit. In these cases, 你的神经外科医生会用局部麻醉麻醉你的皮肤，并在你的头皮上做一个1英寸的小切口. 他或她会在你的头骨上钻一个小洞，然后插入一个叫做硬脑膜下引流系统的装置，轻轻地把血液排出来.
For brain surgeries in the operating room, your neurosurgeon will put you to sleep under general anesthesia. 你的神经外科医生会在你的头骨上开一个小洞，或者取下一块头骨（手术后更换），将引流管插入慢性硬膜下血肿. The subdural hematoma will gently drain away within two to four days.
Middle Meningeal Artery (MMA) Embolization
MMA embolization is a minimally invasive, 在大发娱乐最先进的神经介入放射室进行非手术治疗. It takes about 30 minutes and typically requires light sedation, not general anesthesia that puts you to sleep.
Your surgeon will insert a catheter (a thin, 柔性管)插入大腿动脉，并将其穿入脑膜中动脉——脑膜中动脉在皮质覆盖的大脑内运行, called the dura. 这条动脉负责为慢性硬膜下血肿供血.
接下来，你的外科医生将通过导管插入栓剂（用于阻断血液流动）. 这种物质会一直被推入脑膜中动脉直到它到达硬膜下血肿处切断血肿的血液供应. 这允许身体在接下来的几天或几周内自行分解慢性硬膜下血肿.
Advantages of MMA Embolization
As a non-surgical alternative, 接受MMA栓塞包括更短的住院时间和更快的恢复. This is commonly used as a stand-alone treatment for a patient with a chronic subdural hematoma. In some cases, 如果最初的脑外科手术治疗慢性硬膜下血肿不成功，你的神经外科医生可能会推荐MMA栓塞作为后续治疗. 这已被证明可以减少血肿复发的风险，减少需要再次手术引流的机会.
Chronic Subdural Hematoma Prognosis
通过有效的治疗，绝大多数慢性硬膜下血肿会消失. 许多患者还会注意到头痛等症状的减轻, improved walking, and more energy. 初始治疗后，你的神经外科医生将进行后续测试. If the hematoma returns or remains in your brain, your doctor will discuss additional treatment options and next steps with you.
Make an Appointment with Our Neurosurgeons
大发娱乐的神经外科医生在治疗急性和慢性硬膜下血肿方面有广泛的培训和经验. If you would like to see one of our specialists, please call 801-585-6065 or request an appointment online. Physician referrals are welcome but not necessary.
Hear From Our Patients
Judd Jones, an active 83-year-old business owner, was taking a shower when he slipped and fell and hit his head. More than a month later, he was working in the yard when one of his arms, neck, and back started to tingle. However, it went away. 第二天，他又经历了同样的麻木和刺痛，开始“胡言乱语”." His wife took him to the emergency room. The doctors diagnosed him with a chronic subdural hematoma, most likely caused by his fall in the shower weeks prior.