Unlike the chronic subdural hematoma, acute subdural hematoma is a very severe condition with approx. 50% mortality. It is commonly seen in severe traumatic brain injuries and may coexist with other lesions, such as epidural hematoma and intracerebral hemorrhage. Clinically the patient’s neurological picture is poor, and if the hematoma is not removed, the patient rapidly progresses. In some cases, if the hematoma is small, does not cause displacement of the brain and the neurological image is good, the patient can be monitored in the hospital, having a clinical evaluation of his neurological clinical image and a repeat CT in a few days to see if the hematoma is absorbed. In such cases, it may develop into chronic hematoma.
Surgery, when required, removes the hematoma and usually one or more injured veins are identified in the area between the meninges and the brain. After surgery, the patient may be required to remain in the intensive care unit to treat and prevent possible cerebral edema and ischemia. Older people have a worse prognosis, and use of anticoagulants before the injury has a negative effect on the prognosis. Many of the surviving patients present with severe disabilities, and their recovery process is long and painstaking.