Chronic Subdural Haematoma Treatment in Sharjah
Medically reviewed by Dar Al Kamal Team
What is a chronic subdural haematoma?
A chronic subdural haematoma is a collection of old blood that builds up gradually on the surface of the brain, beneath the tough outer membrane called the dura. Treatment usually means draining that fluid through one or two small holes in the skull, so the brain can expand back into its normal space.
The bleed starts from small veins that bridge the gap between the brain and the skull. As people age, the brain shrinks slightly and these veins become stretched, so a minor knock, sometimes one the person has forgotten, can tear one. The blood oozes slowly, and over the following weeks it turns into a thin, dark fluid often described as looking like engine oil. A thin membrane forms around it and can keep leaking, which is why the collection grows.
At Dar Al Kamal Hospital, Sharjah, this condition is treated by the consultant neurosurgeon. Acute bleeds straight after a serious injury follow a different path, covered under head injury management.
Who needs it
Chronic subdural haematoma is most common in older adults, people taking blood-thinning or antiplatelet medicines, people who drink heavily and people prone to falls. Symptoms build over days or weeks and are easily mistaken for ageing, dementia or a stroke:
- Headache that gradually worsens
- New confusion, forgetfulness or drowsiness
- Unsteadiness and falls
- Weakness or clumsiness on one side
- Difficulty finding words
A CT scan of the head confirms the diagnosis quickly. Families often provide the key clue, noticing a relative has become slower or more muddled since a fall some weeks earlier.
Small collections with mild symptoms are often watched with repeat scans, while blood thinners are reviewed. Drainage is recommended when the collection is causing symptoms or pressing on the brain. The surgeon weighs the scan, the symptoms and the person's overall health, and discusses the choice with the patient and family.
What happens
Burr-hole drainage is performed under general anaesthesia or, for some patients, local anaesthetic with sedation. A small area of hair is shaved, and one or two short incisions are made over the collection.
The surgeon then:
- Drills one or two small round holes, each about the size of a fingertip, through the skull.
- Opens the dura and lets the old blood drain out.
- Washes the space gently with warm saline until the fluid runs clear.
- Often leaves a soft, thin drain under the scalp for a short time to let remaining fluid escape.
- Closes the skin with stitches or clips.
Where the collection has thick internal walls, a larger opening called a mini-craniotomy may be used instead. Afterwards, you lie fairly flat while the drain is in, to help the brain re-expand, and the nurses check alertness, speech and limb strength regularly.
Preparing for it
The most important preparation is a clear list of every medicine, especially blood thinners, antiplatelets and diabetes medicines. The team may reverse or pause blood thinners before surgery, with a plan for when to restart them agreed with the doctor who prescribed them.
Blood tests check clotting. Families help by describing how the symptoms began and the person's usual abilities, and by bringing glasses, hearing aids and a list of home support. Arrange for someone to stay with the patient after discharge.
Afterwards
Recovery is usually gradual. Confusion and weakness tend to ease over days to weeks as the brain re-expands. Walking with help begins once the drain is out, and physiotherapy supports balance and confidence.
Falls prevention is part of treatment: good lighting, removing rugs, grab rails and sensible footwear all help. Keep the wound clean and dry and follow advice on hair washing, which matters in the Sharjah heat. Drink plenty of water, and discuss Ramadan fasting with the team beforehand. A follow-up scan is often arranged to check the space is settling.
Contact the hospital if the wound leaks, reddens or swells, or if a fever develops. **Go to the emergency department straight away if headache, confusion, drowsiness, weakness or speech difficulty returns or worsens, or if a seizure occurs.**
Cost and insurance
UAE insurance plans generally cover burr-hole drainage when it is medically needed. Emergency admissions are notified to the insurer, while planned drainage and follow-up scans usually need pre-approval supported by the CT report. Dar Al Kamal Hospital, Sharjah can help you confirm cover on 06 599 7777.
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Frequently asked questions
What are the risks of burr-hole drainage?
Burr-hole drainage carries the risks of any brain operation, including infection, fresh bleeding, seizures, air trapped inside the skull and a reaction to the anaesthetic. The collection can also re-form after drainage and sometimes needs a second procedure. Your surgeon explains how these risks apply to you.
Can a chronic subdural haematoma come back?
A chronic subdural haematoma can re-form after drainage, particularly in people who need to continue blood thinners or who fall again. Follow-up scans and prompt review of returning symptoms allow any recurrence to be treated.
Can a chronic subdural haematoma go away without surgery?
Small chronic subdural haematomas with mild symptoms sometimes shrink on their own and are monitored with repeat scans. Larger collections or those causing confusion, weakness or drowsiness usually need drainage.
Why did symptoms start weeks after the fall?
Symptoms of a chronic subdural haematoma often start weeks after a fall because the blood collects slowly and the brain has spare room at first, particularly in older adults. Symptoms appear only once the collection is large enough to press on the brain.
When can blood thinners be restarted?
Blood thinners are restarted after burr-hole drainage once the surgeon judges the risk of re-bleeding has settled. The timing is agreed between the surgeon and the doctor who prescribed the medicine, balancing the bleeding risk against the reason you take it.
Will I have a visible scar?
The incisions for burr-hole drainage are short and usually lie within the hairline, so they are hidden as hair grows back. A small dip in the scalp over each hole is sometimes felt.
Is this the same as a stroke?
A chronic subdural haematoma is a collection of blood outside the brain, whereas a stroke is a blocked artery or a bleed within the brain tissue. The symptoms can look similar, so a CT scan is used to tell them apart.
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