The 65-year-old Wang has a very rich retirement life.
Fishing during the day and square dancing at night. It's not that I really like to dance, I just want to "chat" with the old ladies in the team.
On this day, Lao Wang "chatted" with the old ladies as usual, but encountered a hard stubble, the new Aunt Zhao in the team was not used to him, and he was speechless and angry with a "old teapot spout", and was just about to stand up and move, and his head hit the horizontal bar.
The more Lao Wang thought about it, the more embarrassed he became, patted the dust on his body, and slipped away as if he had escaped.
Since then, it has become the laughing stock of the community.
I'm embarrassed to tell my children about it afterwards. After half a month, he began to be forgetful, had headaches, and did not speak in the first and second words.
The children suspected that he had Alzheimer's disease, and despite Wang's objections, they forced him to take him to the hospital for treatment.
It's just a knock, how did it get to the point of surgery?
What exactly is this chronic subdural hematoma?
Chronic subdural hematoma is an intracranial hemorrhagic disorder, accounting for about 10% of intracranial hematoma cases, usually due to bleeding caused by head trauma or rupture of intracranial blood vessels, and the gradual accumulation of blood under the cerebral dura.
"Intracranial hemorrhage", if you just take out these four words, you will know the seriousness of the matter as soon as you hear it, but what causes this serious consequence is often just a casual little thing in life.
Chronic subdural hematoma can be caused by hitting the edge of a bed while sleeping, coughing violently, hitting your head on a horizontal bar, being hit on the head by a bear child with a hard toy, or even a concussion caused by a sudden braking.
However, due to the fact that there is not much pain at the time of injury, it generally does not attract the attention of yourself and your family, and the intracerebral venous blood vessels may have already caused damage, compared with acute subdural hematoma, the symptoms of chronic subdural hematoma may develop more slowly, and symptoms such as headache, nausea, vomiting, consciousness disorder, and neurological loss gradually appear for more than 2 weeks.
If left untreated, chronic subdural hematomas can lead to serious neurological complications that can be life-threatening.
The prevalence of chronic subdural hematoma increases with age, and is generally 2 to 3 times higher in men than in women, which may be related to the fact that men are more susceptible to head trauma.
Although chronic subdural hematoma has some symptoms, it is not specific and is similar to the symptoms of other brain diseases, and has no typical features, so it is easy to be confused with other diseases.
For example, cerebral infarction, its symptoms and signs are similar to chronic subdural hematoma, if you do not go to the hospital at this time, you take blood-invigorating drugs by yourself, intracranial hemorrhage will increase rapidly, which will lead to aggravation of the condition.
For mild chronic subdural hematoma, when the volume of fluid is not large and the capsule is not very thick, oral statin drugs can be used to promote hematoma resorption, monitor changes in the condition, and repeat examinations regularly.
If you do not absorb it and you have symptoms such as headache, nausea, and vomiting, you may need surgery to drain your head by drilling holes.
As the name suggests, this surgery involves drilling a hole in the head→ placing a catheter into a hematoma in the head→ injecting hemolytic drugs into it →to dissolve the clot → drain the bleeding clot.
If the situation is more complicated, a craniotomy may be required.
However, the prognosis of chronic subdural hematoma is relatively good, and there are generally no sequelae, and early diagnosis and treatment should be made if possible.
Of course, the most important thing is to try to avoid head hits, especially for the elderly!
• Cough gently and avoid pushing too hard
• Move gently when exercising, avoid bumping, and don't be impulsive and irritable like Lao Wang, who is prone to accidents
• If there is a bump in the brain, it should be examined in time to actively prevent the occurrence of subdural hematoma
• Patients with high blood pressure, the elderly who take anticoagulant and antiplatelet drugs for a long time are all high-risk groups, and they should pay more attention to avoid bumps on weekdays
Resources:
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[2] UnoM， ToiH， HiraiS. Chronic subdural hematoma in elderly patients： is this disease benign？[J]. Neurol Med Chir， 2017， 57(8)： 402-409. DOI： 10.2176/nmc.ra.2016-0337.
[3] Tian Y，Wang D，Zhang XJ，et al. Establishment and validation of a prediction model for self-absorption probability of chronic subdural hematoma[J]. Front Neurol，2022，13(7)：913495.
[4] Stubbs DJ， Vivian ME， Davies BM， et al. Incidence of chronic subdural haematoma：a single-centre exploration of the effects of an ageing population with a review of the literature [J]. Acta Neurochir( Wien)，2021，163(9)：2629-2637.
[5] Yang Chunmei, Yan Xiufen, Liu Chunyan. Analysis of 18 cases of chronic subdural hematoma misdiagnosed as cerebral infarction[J]. Journal of Stroke and Neurological Disorders, 2007, 24(6): 735
[6] Hu Kai, Zhang Hua.Research progress on the pathogenesis and treatment of chronic subdural hematoma[J].Journal of Clinical Neurosurgery,2024,21(1):102-105109