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Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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A craniotomy is seldom necessary to treat a subdural haematoma. Management depends upon the age of the patient.

In infants:

  • evacuate haematoma through the anterior fontanelle by repeated needle aspiration
  • subdural peritoneal shunt for persistent subdural collections

In adults:

  • patients in whom conscious level is depressed:
    • evacuate haematoma through 2-3 burr holes, and irrigate cavity with saline
    • nursing in the head down position is recommended to prevent recollection


  • a 2-week course of oral dexamethasone was associated with fewer favourable outcomes and more serious adverse reactions than placebo in older patients (average age 74 years) with chronic subdural haematoma (1)


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