Subdural hematoma classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.
Overview
There are 3 classification system for subdural hematoma. Subdural hematoma may be classified according to symptom onset and duration into 3 subtypes including acute, subacute, and chronic, according to midline shift and thickness into 4 subtypes, and based on imaging findings into 6 subtypes.
Classification
There are 3 classification system for subdural hematoma:[1][2]
- Subdural hematoma may be classified according to symptom onset and duration into 3 subtypes:
- Acute: Develop less than 24 hours after head trauma (or other subdural hemorrhage causes)
- Subacute: Develop between 1 to 10 days after head trauma (or other subdural hemorrhage causes)
- Chronic: Develop weeks or months after head trauma (or other subdural hemorrhage causes). It can be further divided into 5 grads:
- Grade 0: Normal patient with no symptom
- Grade 1: Patient has headache and mild or no neurological abnormalities but is alert
- Grade 2: Decreased level of consciousness (drowsiness) with neurological abnormalities
- Grade 3: Sever focal neurological deficit and loss of consciousness but response to pain stimuli
- Grade 4: Coma with no response to pain stimuli
- Subdural hematoma may be classified according to mid-line shift and thickness into 4 sub-types:
- Type A: Thickness ≤ 1cm, midline shift ≤ 5 cm
- Type B: Thickness > 1cm, midline shift ≤ 5 cm
- Type C: Thickness > 1cm, midline shift > 5 cm
- Type D: Thickness ≤ 1cm, midline shift > 5 cm
- Subdural hematoma may be classified according to imaging findings into 6 subtypes:
- Type 1: Hyperdense lesion, relatively homogeneous (describes acute subdural hemorrhages)
- Type 2: Isodense lesion, relatively homogeneous (describes subacute hemorrhages)
- Type 3: Hypodense, relatively homogeneous (describes chronic hemorrhages)
- Type 4: Isodense to hypodense, relatively heterogeneous (describes recent rebleeding)
- Type 5: Hypodense in its liquefied component, relatively heterogeneous; internal septations and loculations (higher risk for recurrence after surgical treatment)
- Type 6: Calcified hyperdense, relatively homogeneous (describes subdural hemorrhage with calcified component)
References
- ↑ Alves JL, Santiago JG, Costa G, Mota Pinto A (September 2016). "A Standardized Classification for Subdural Hematomas- I". Am J Forensic Med Pathol. 37 (3): 174–8. doi:10.1097/PAF.0000000000000255. PMID 27428027.
- ↑ Salahuddin T (February 1996). "Management of chronic subdural haematoma--a review of 23 cases". J Pak Med Assoc. 46 (2): 32–3. PMID 8683845.