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I've had a Chronic subdural hematoma for 4 months and have a few questions.

I hit my face on a counter edge in April which gave me a laceration and, 2 weeks later
began noticing what was diagnosed as Chronic Subdural Hematoma based on initial
CT.  Initially had high pressure and painful headaches, but No neuro symptoms. The headaches
and pressure sensation have since subsided. Neurosurgeon allowed a watch and wait approach,
based on 2nd CT. A follow up this past week (about 8 weeks later)  showed the CDSH volume
minimally larger - 0.1 cm thickness, superiorly  With no symptoms, Neuro said we could
check again with another scan in abt. 2-3 months.  So there's the history thus far. In hopes
of avoiding surgery for drainage, I am hoping for blood resorption spontaneously and have
researchedextensively for all medication or otherwise. Nothing very definitive but clinical trials
have shown Atorvastatin may help in decreasing the hematoma volume.  My Dr. prescribed
it this week. I have also read about TCM WuLingSan, aka Goreisan as a prescribed medication
in Japan for CDSH with some favorable results reported.

What is unclear is whether doing certain things in my daily routine such as intensive computer
work or mental exertion might impact this condition.  I ask because one symptom that I have
had from the outset has been what seems like Pulsatile Tinnutis.  This comes and goes but
it seems related to blood pressure and any degree of stress. A sensation of pulsing in sync
with heartbeat in the right ear.  Could this be in any way enlarging or affecting the hematoma?
If there is "ooze" of blood, that is especially a concern...

I have  limited physical activity and been extremely careful, no blood thinning agents or
alcohol for the duration of this.  I would love to know if it is simply possible that a natural
healing process could actually take a very long time, i.e., up to a year??   Meantime
would like to be doing every conceivable thing to help that happen.  

The burr hole surgery is commonly done esp. for symptomatic cases but I am not, other
than the pulsation thing.  I have also read about a newly developed surgery involving
meningeal embolation where the artery that is supplying blood to the hematoma is
cauterized, and the hematoma resolves.  This does make sense but it IS a procedure...
albeit arguably less invasive than the burr hole treatment which does not guarantee
the CDSH won't return.  

Sorry for the length but alot to go through and wanted to be as specific as possible. I
would really appreciate anyone's thoughts, experience and opinions on any of this.
It's been literally 'on my mind' most of the year.  Thank you very much for your time,

Mike

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Avatar universal
My father became symptomatic with left leg weakness and numbness, and subsequent diagnosis of subdural hematoma. We learned that likely a blow to the head caused a slow bleed, and probably 4-5 months earlier, as the blood was old and the consistency of motor oil. When blood like this ages, it expands, and eventually causes symptoms. He had developed a mid-line shift, and on CT, it literally looked as though 1/3 of his brain was blood. He was given the option of waiting to see if the blood good gradually be resorbed, or proceed with burr-hole surgery. Since he lived alone, an was basically at risk of falling because his symptoms had quickly appearred and worsened, he elected to have the burr-hole surgery. We were told that he would have to lie flat for 48 hours after the surgery, to allow gravity to help the brain to move back into place once the blood was drained out. He did so well after the surgery that he was sitting up eating breakfast the next morning. I questioned several people about this, and was told that he was doing so well the doctor changed the orders. I believed at the time this was a mistake and the doctor should not have rushed through this part of the post op protocol. But, my father quickly became asymptomatic, was walking and energetic, and looking forward to getting back to his routine. He was in the hospital for 6 days, then he went to rehab for 10 days.  It was supposed to be 7 days in the hospital and 14 days in rehab...because the first 3 weeks after surgery is considered a 20% risk of bleeding due to the riskiness of the surgery. He excelledin rehab, and actually enjoyed it. When the PT asked him to do 10 reps, my dad did 20 reps. I was very proud of him. The last couple of days in rehab, he seemed a little confused, and his dreams seemed real to him. His first afternoon home, he wanted to go to the bank and Post Office, and lunch out. His second day home was calm and just stayed home. His 3rd morning, he went to a neighbors for coffee, had a visior bring him soup for lunch, and then he went to his home office to check email. Something happened, and he must have known something was going wrong in his head. He had braced himself in his chair with both hands grasping a walking stick. The coroner said he had had a hemorrhage most likely due to the surgery which carried a risk of bleeding. We found an empty glass of what was red wine from the night before, and I wonder if that contributed to the bleeding...he was not told he could not have that. He refused to let us stay with him, because he was doing so well.  My point in telling you all this is that the burr hole surgery has risks because of the drilling through the many blood vessels, and when a patient may be confused due to the blood or trauma of the blood, they may not be cautious or do those preventative things to be safe. There are real risks with this procedure,but when symptomatic, there may be no other choice.  All the best to you, and hope you can wait it out until it just disappears.
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