Today we are going to talk about is a hard currency, all students can listen carefully, especially the elderly at home must look carefully, things are like this – an old man, the body has been very strong, every morning to go downstairs to the park to walk and exercise, but also often with the old guys to drink tea and play chess, but just a week ago, suddenly felt that walking legs feel weak, at first thought it was not well rested and did not care very much, but in the past few days always headache and more and more serious, but also often lose a lot of time. But just a week ago, suddenly feel walking legs feel no strength, at first thought it was not a good rest, and did not pay much attention to, but these days always headache and more and more serious, but also often lose three or four. Accompanied by his family members, he went to the hospital and underwent a CT examination of his head, and the result was very surprising: the CT showed that there was a chronic subdural hematoma in the left frontal-temporal parietal region of the old man’s head! The family is very puzzled, no bump no touch where the bleeding? Here is a quick overview of the basic anatomy: a subdural hematoma is a hematoma that occurs between the dura mater and the arachnoid membrane. There are three membranes between our brain tissue and the skull, the one immediately below the skull is called the dura mater, below it is the arachnoid membrane, and the one immediately below the surface of the brain is the soft meninges. The so-called chronic subdural hematoma is a special type of subdural hematoma, which is located between dura mater and arachnoid membrane with intact peritoneum more than three weeks after the injury, and the incidence accounts for about 10% of intracranial hematomas, of which more than 90% are the old people, and the hematoma often occurs in the front-parietal-temporal hemisphere convexity, and the volume of accumulated blood can reach 100-300 ml. The symptom of increased intracranial pressure is the main cause. Symptoms mainly include increased intracranial pressure, headache, nausea, memory loss, slow reaction and mild limb movement disorder. Chronic subdural hematoma may appear as a “crescent shape” on CT of the head. Note: Chronic subdural hematoma is more common in the elderly! Because the brain tissue and cerebral blood vessels of middle-aged and old people shrink physiologically, while the skull does not shrink, which leads to the gap between the dura mater and the brain parenchyma is larger than in the young age, the space between the brain tissue and the skull provides a large amount of blood field, and it is precisely because this space can accommodate hematoma, so that the symptoms often appear later. When head trauma, or even no obvious trauma, the elderly due to the increase in the cranial cavity space, brain tissue in the cranium of the greater mobility, so that the brain surface of the cortical bridge vein is more likely to be stretched in traumatic brain injury and break bleeding, this bleeding is intermittent, slow, coupled with the elderly cerebral atrophy, lower intracranial pressure, increased venous tension or coagulation mechanism disorders and other factors, so that the hematoma continues to expand until the emergence of symptoms. Therefore, the elderly have become a favorable population for chronic subdural hematoma. Moreover, due to the decreased elasticity of blood vessels in middle-aged and old people, as well as long-term oral aspirin, Polivir and other anti-platelet coagulation drugs, resulting in reduced coagulation function, so that the body is in a state prone to bleeding. What about chronic subdural hematoma? In general, if the bleeding is not excessive and the patient is not experiencing symptoms of their own discomfort, conservative treatments can be taken, such as the use of medications to promote the absorption of the hematoma, regular review of the head CT, and prompt medical attention if symptoms of discomfort occur. For most patients, hematoma is difficult to absorb on its own and most of them will increase, so surgery is the fastest and most effective treatment. Depending on the size and location of the hematoma, the vast majority of patients can be treated by drilling a hole to drain the hematoma, while a few patients require craniotomy to remove the hematoma. The majority of patients have a good outcome, and only a small number of patients will have a recurrence and require reoperation. (Chronic subdural hematoma drilling drainage before and postoperative day 1 CT control) Craniotomy hematoma removal is only applicable to those who are not cured by closed drainage, or there are a large number of blood clots in the cavity, or there is a separation in the cavity of the hematoma that is not conducive to drilling drainage, as this method is not preferred due to the large surgical trauma. Elderly people should prevent the occurrence of trauma in daily life, prevent falls, stay away from the risk factors of injury, it is best to have a family member to accompany them, patients with other diseases, such as hypertension, diabetes mellitus, or long-term use of aspirin, poliovir and other anticoagulant drugs, the crowd, it should be strengthened to pay attention to, if the head has suffered head trauma, or even minor trauma, we must be vigilant about the occurrence of chronic subdural hematoma, once the Early symptoms such as headache, dizziness, etc., please consult a doctor in time, early detection and early treatment will get better results.