Subduraali

Subduraali, in anatomical usage, refers to the subdural space, a potential space between the dura mater and the arachnoid mater. Normally this space is not open, but it can become a real space when material such as blood, CSF, pus, or other fluid accumulates due to injury, infection, or surgical intervention. Conditions connected with the subdural space are collectively described as subdural processes, with subdural hematoma being the most common.

Subduraali hematoma is a collection of blood in the subdural space. It most often results from trauma that tears bridging veins, but anticoagulant or antiplatelet use and brain atrophy in the elderly increase risk. Acute subdural hematomas develop within 72 hours of injury; subacute bleedings evolve over days to weeks; chronic subdural hematomas may become evident weeks or months after the event. Symptoms include headache, confusion or reduced consciousness, vomiting, and focal neurological deficits. Diagnosis is usually by head CT or MRI, which reveal crescent-shaped collections that may be hyperdense in acute stages and progressively hypodense as they organize.

Other subdurally related conditions include subdural empyema, an infectious collection in the subdural space requiring urgent surgical drainage and antibiotics; and subdural hygroma, a CSF-like collection that can arise after head trauma or surgery and may resolve spontaneously or require drainage if persistent or enlarging.

Diagnosis and management hinge on clinical presentation and imaging findings. Treatment ranges from careful observation for small, asymptomatic cases to surgical intervention (drainage or evacuation) for larger or neurologically compromising hematomas, often combined with treatment of underlying risk factors and, in infectious cases, appropriate antimicrobial therapy. Prognosis depends on age, hematoma size, timing of treatment, and comorbidities.