Blood in the Subdural Spaces
Collections of blood that form in the subdural space in the brain are common in patients 50 years and older, with head trauma the common cause. The subdural space is the area between the brain surface and the dura (covering) of the brain. Veins in the dura can be stretched during trauma to the extent that they are injured and bleed. It is well-known that subdural blood accumulation will not always be apparent on initial radiological studies following injury. In fact, it may take several weeks for blood to show up in this space. The mechanism for this latter scenario involves the veins initially clotting off but then reopening. This delayed bleeding results in blood accumulating, but not until the days and weeks that follow, eventually becoming symptomatic. A collection of blood in the subdural space can be very small and not require surgery, but when a blood collection in this space becomes more extensive, it can cause mass effect on the brain, becoming life-threatening and requiring emergency surgery.
Blood in the Subdural Spaces medical expert witness specialties include neurosurgery, neurology, anesthesiology, obstetric anesthesiology, pain medicine and neuroradiology.