Subdural haematomas are usually precipitated by traumatic head injuries. How common are non- traumatic spontaneous subdural haematomas in autopsy practice? What are the risk factors for developing such a spontaneous event?
Subdural haematomas are usually of traumatic aetiology. However, there are a few cases reported when they occurred spontaneously. Risk factors included hypertension, vascular malformations, neoplasia such as haematological malignancies causing thrombocytopaenia, solid tumour dural metastases, infection, hypervitaminosis, coagulopathy and alcoholism. Sometimes, in elderly people these haematomas appear to be spontaneous because they occurred after minor trauma and were chronic so patient doesn't report head trauma.
There are some reports of subdural heamtomas after Valsalva manoeuvre (VM) in weight lifters taking anabolic steroids - e,g, http://www.ncbi.nlm.nih.gov/pubmed/15565482
I totally agree with Kristijan Becic and trivial un-noticed trauma is guite a common cause, especially in the elderly and alcoholics.
Dear Ali
Chronic subdural hematoma can occur spontaneously, and being elderly is perhaps the no. 1 risk factor for developing this condition and that it can occur "spontaneously" due to weakened bridging veins, and brain atrophy.
If elderly people take daily aspirin or other anticoagulants, this increases risk even more
There are few documented cases of spontaneous subdural hematoma in healthy young men. Risk factors included hypertension, vascular malformations, neoplasia such as haematological malignancies causing thrombocytopaenia, solid tumour dural metastases, infection, hypervitaminosis, coagulopathy , alcoholism.
In a rare occasion may result from intracranial hypotension secondary to systemic vascular hypotension, arising from dehydration acquired while marathon training
I've seen "spontaneous" subdural hematoma after childbirth. In elderly persons, there may be "minor" or "insignificant" trauma that is not remembered. We have some online videos on subdural hematoma:
http://www.youtube.com/watch?v=jiscvATspCA
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