Table 3.

Headache attributed to subdural haematoma²

Headache attributed to subdural haematoma

Diagnostic criteria: Acute or progressive headache, no other typical characteristics known, fulfilling criteria C and D Neuroimaging evidence of subdural haematoma Headache develops within 24–72 hours after the development of the haematoma One or other of the following headache resolves within 3 months after evacuation of the haematoma headache persists but 3 months have not yet passed evacuation of the haematoma

Comments:Different types of subdural haematomas should be differentiated according to their temporal profile. In acute and subacute haematomas, which usually occur after obvious head trauma, headache is frequent (11–53%) but commonly overshadowed by focal signs and disorders of consciousness. In chronic subdural haematomas, headache is more frequent still (up to 81%) and, though moderate, can be the leading symptom. The diagnosis can be difficult, because the causative head trauma is often trivial and may have been forgotten by the patient. Chronic subdural haematoma should always be considered in an elderly patient with a progressive headache particularly if there is some cognitive impairment and/or mild focal signs.