On Acute Subdural Hematomas

Acute subdural hematomas are a type of terrible traumatic brain injury. Any time that I've bumped my head in my life, the catastrophizer in me immediately believes that I have a subdural hematoma. This fear began when I hit my head on a can recycler at work a few years ago. Blood running down my face, I sought the advice of a a co-worker who had trained as a paramedic. "How does it look?" I asked anxiously as he rooted around my scalp.

"I think it's just a bump," he replied. "But if you start to have a headache or feel drowsy, you might want to head to the ER. I've seen even slight bumps turn out to be subdural hematomas, and the person's up and walking around and saying they're fine, and 12 hours later they're in a coma or dead."

And so it began. The worst part about a subdural hematoma is that it can have a fairly slow onset, so the person might seem fine initially after the injury. While acute hematomas are most common with severe injury or trauma, this isn't always the case, as my paramedic friend pointed out. Even a slight fall can damage the veins and cause a rupture. And finally, acute hematomas have a very high mortality rate. All of this equals my worst nightmare.

Today, when I read the news about the actress Natasha Richardson, it brought my hematoma fears front and center. The story as it's unfolding is: she was skiing on a beginner's slope, she fell, it didn't seem very serious and she seemed fine for an hour or so until she began to complain of a headache. Now, she's in critical condition.

While I'm not sure we're talking acute subdural hematoma, I'm guessing. And of course I'm wishing her well.

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