subdurale

Subdurale, or subdural, refers to the potential space between the dura mater and the arachnoid mater, two of the membranes enclosing the brain and spinal cord. In a healthy state this space is not a true cavity, but it can become exposed or expanded by injury, aging, or disease. Pathological contents in this space include blood (subdural hematoma), cerebrospinal fluid (subdural hygroma), or purulent material (subdural empyema).

Subdural hematoma is the most common subdurale condition. It is classified as acute (within 72 hours of injury), subacute (3–14 days), or chronic (more than 14 days). The injury usually involves tearing of bridging veins during head trauma, with elderly individuals and those on anticoagulants at higher risk. Symptoms range from headache and confusion to focal neurological deficits and decreased consciousness, depending on size and rate of bleeding.

Diagnosis is typically made with neuroimaging, most often computed tomography (CT), which shows a crescent-shaped extra-axial collection along the brain surface. Magnetic resonance imaging (MRI) can provide additional detail, especially for chronic cases. Treatment depends on the hematoma’s size and clinical impact: small and asymptomatic hematomas may be observed, while larger or symptomatic ones usually require surgical evacuation, such as burr-hole drainage or craniotomy, along with management of coagulation status.

Other subdurale conditions include subdural hygroma, a CSF collection that can occur after trauma or surgery due to arachnoid rupture, and subdural empyema, a pus-filled subdural collection typically resulting from infection. Prognosis improves with prompt diagnosis and appropriate intervention, though chronic subdurales may have a higher risk of recurrence.