Your Care Instructions

A subdural hematoma is a buildup of blood between the layers of tissue that cover the brain. The blood collects under the layer closest to the skull. (This layer is called the dura.) The bleeding is most often caused by a head injury, but there can be other causes. In a young child, even a minor injury can lead to a subdural hematoma.

The buildup of blood inside the skull can put pressure on a child's brain. This may cause symptoms, such as a severe headache, confusion, or seizures.

There are two kinds of hematomas: acute and chronic.

• With an acute hematoma, symptoms start soon after the injury.
• With a chronic hematoma, it may be days or weeks before symptoms appear.

Your child may have had a test such as a CT scan or MRI. The doctor may also have done a test to check the pressure inside your child's skull.

Bleeding inside the skull may get worse over time. So it is very important to pay attention to your child's symptoms. And be sure your child sees a doctor for follow-up testing.

In some cases, treatment is needed to remove the blood. This helps relieve the pressure on the brain. The doctor may make one or two small holes in the skull. For a large hematoma, the doctor may need to remove a piece of the skull.

Your child may not need treatment if the buildup of blood is small and is not causing symptoms.

If your child takes aspirin or some other blood thinner, he or she may need to stop taking it. The doctor may give your child treatment to undo the effects of the blood thinner. This can help prevent more bleeding in the skull.

The doctor has checked your child carefully, but problems can develop later. If you notice any problems or new symptoms, get medical treatment right away.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

How can you care for your child at home?

For an acute hematoma

• Follow instructions from your child's doctor. He or she will tell you if you need to watch your child closely for the next 24 hours or longer.

For a chronic hematoma

• Make sure that your child gets plenty of sleep at night. Your child also needs to take it easy during the day.
• Help your child avoid activities that take a lot of physical or mental work. This includes exercise, schoolwork, video games, text messaging, housework, and using the computer.
• Let your child return to normal activities slowly. Your child should not try to do too much at once.

For either type of hematoma

• If your child takes aspirin or some other blood thinner, be sure to talk to your doctor. He or she will tell you if and when your child can start taking this medicine again. Make sure that you understand exactly what your doctor wants you to do.
• If your child normally takes medicine, your doctor will tell you if and when you can restart it. He or she will also give you instructions about taking any new medicines.

When should you call for help?

Call 911 anytime you think your child may need emergency care. For example, call if:

• Your child has a seizure.
• Your child passes out (loses consciousness).
• Your child is confused or can't stay awake.

Call your doctor now or seek immediate medical care if:

• Your child has new or worse vomiting.
• Your child is less alert.
• Your child has new weakness or numbness in any part of the body.
• Your child has a headache that is getting worse.

Watch closely for changes in your child's health, and be sure to contact your doctor if:

• Your child does not get better as expected.
• Your child has new symptoms, such as headaches, trouble concentrating, or changes in mood.