Summary about Disease
A subdural hygroma is a collection of cerebrospinal fluid (CSF) or less commonly, blood breakdown products, located in the subdural space. The subdural space is the area between the dura mater (the outermost membrane covering the brain) and the arachnoid mater (the next layer inward). Subdural hygromas are often caused by head trauma but can also occur spontaneously or as a complication of other conditions. They can be asymptomatic, especially if small, or can cause symptoms due to pressure on the brain.
Symptoms
Symptoms can vary based on the size and location of the hygroma, as well as the age of the patient. In infants, symptoms may include:
Increased head circumference
Bulging fontanelle (soft spot on the head)
Irritability
Lethargy
Vomiting In older children and adults, symptoms may include:
Headache
Nausea/vomiting
Drowsiness
Confusion
Seizures
Changes in behavior or personality
Difficulty walking or balancing
Weakness on one side of the body
Speech difficulties
Vision changes
Causes
The most common cause of subdural hygroma is head trauma, even minor head trauma. This trauma can tear small bridging veins that connect the brain surface to the dura mater, leading to CSF leakage into the subdural space. Other causes include:
Spontaneous rupture of arachnoid cysts
Complications of brain surgery
Shunt malfunction (in patients with hydrocephalus)
Meningitis
Dehydration
Anticoagulation therapy
Medicine Used
There is no specific medicine to "cure" a subdural hygroma. Treatment primarily focuses on managing symptoms and, if necessary, reducing the size of the fluid collection. Medications that may be used include:
Pain relievers: For headaches
Anti-seizure medications: If seizures occur
Osmotic diuretics (e.g., Mannitol): In some cases to reduce intracranial pressure temporarily. However, these are used cautiously.
Corticosteroids: May be used to reduce inflammation and swelling, but generally avoided due to potential side effects. The primary treatment for a symptomatic subdural hygroma is often surgical drainage.
Is Communicable
No, subdural hygromas are not communicable. They are not caused by infectious agents and cannot be spread from person to person.
Precautions
Precautions depend on the cause and severity of the hygroma. General precautions include:
Head protection: Following head trauma, appropriate head protection (e.g., helmets) should be used to prevent further injury.
Monitoring: Close monitoring for any neurological changes is crucial, especially after head trauma.
Medication adherence: If medications are prescribed, adhere to the prescribed dosage and schedule.
Fall prevention: For individuals with balance or gait difficulties, take measures to prevent falls.
How long does an outbreak last?
Since subdural hygromas aren't communicable diseases like infections, the term "outbreak" is not applicable. The duration of the condition depends on its cause, size, and whether it is treated. Small, asymptomatic hygromas may resolve spontaneously. Symptomatic hygromas may require drainage. The overall course of symptomatic hygromas can last from a few weeks to several months depending on treatment success and recurrence.
How is it diagnosed?
Diagnosis typically involves:
Neurological Examination: Assessment of neurological function, including reflexes, strength, sensation, and coordination.
Imaging Studies:
CT Scan: A CT scan of the head is usually the first imaging test performed. It can clearly visualize the hygroma and assess its size and location.
MRI: MRI provides more detailed images of the brain and can help differentiate a hygroma from other conditions, such as subdural hematoma.
Timeline of Symptoms
The timeline of symptoms varies significantly depending on the cause and size of the hygroma.
Acute: Following head trauma, symptoms may develop rapidly within hours to days.
Subacute: Symptoms may develop more gradually over days to weeks.
Chronic: Some hygromas may be present for weeks or months before symptoms become apparent. The symptoms themselves can also evolve. Initially, there might be only mild headache or irritability, which may progress to more severe symptoms if the hygroma increases in size and puts more pressure on the brain.
Important Considerations
Differentiation from Subdural Hematoma: It is critical to distinguish a subdural hygroma from a subdural hematoma, as the management approaches can differ.
Underlying Cause: Identifying and addressing the underlying cause (e.g., shunt malfunction) is essential to prevent recurrence.
Monitoring: Even after treatment, ongoing monitoring is important to ensure that the hygroma does not recur.
Age: Management strategies may differ for infants and adults.
Surgical intervention: Surgical drainage may be needed if the condition is symptomatic and not resolving.