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Treatment

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

Notes:

  • 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)

Reference:

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