Contact Information Scan the QR code to learn Neurosurgery Department more about other NNI@TTSH Neuroscience conditions Tan Tock Seng Hospital, NNI Block, Neuroscience Clinic 11 Jalan Tan Tock Seng, Singapore 308433 Main Tel: (65) 6357 7153 Appt. Tel: (65) 6330 6363 Email: [email protected] Website: www.nni.com.sg Scan QR code for NNI@SGH directions Singapore General Hospital, Block 3, Clinic L The National Neuroscience Institute operates out of Outram Road, Singapore 169608 two main campuses (TTSH, SGH) and Main Tel: (65) 6222 3322 four partner hospitals (CGH, KKH, KTPH, SKH). Appt. Tel: (65) 6321 4377 Email: [email protected] Website: www.nni.com.sg NNI @ KTPH NNI @ SKH NNI@CGH NNI@KKH NNI @ TTSH NNI @ CGH Changi General Hospital KK Women’s and NNI @ KKH 2 Simei Street 3 Children’s Hospital Singapore 529889 100 Bukit Timah Road NNI @ SGH Appt. Tel: (65) 6850 3333 Singapore 229899 Appt. Tel: (65) 6294 4050 Chronic NNI@KTPH NNI@SKH Khoo Teck Puat Hospital Sengkang General Hospital 90 Yishun Central 110 Sengkang East Way Singapore 768828 Singapore 544886 Subdural Appt. Tel: (65) 6555 8828 Appt. Tel: (65) 6930 6000 Haemorrhage Brochure content serves as a guide only Seek the advice of your doctor for more details Information correct as of December 2020 Understanding Chronic Subdural Diagnosing CSDH After the surgery, patients must lie at for 24 to 48 hours Haemorrhage (CSDH) for the brain to expand. Most can be discharged within a A detailed history and examination are needed to assess week and rehabilitation can be arranged if needed. Chronic subdural haemorrhage (CSDH) is a collection of mental function, limb strength, coordination, walking blood and uid between the surface of the brain and its and balance. If there are abnormalities, a Computed CSDH may recur in up to 30% of cases and repeat surgery outermost covering known as the dura (Figure 1). Tomography (CT) scan may be needed. may be required. Small veins called “bridging veins” are located between Risk Factors Managing CSDH the surface of the brain and the dura. A subdural haemorrhage can develop after a head injury where Brain atrophy (shrinking of the brain) is one of the major Adopt the following wound care methods after surgery: the veins can tear and bleed. risk factors for CSDH after a head injury. When the head is • Cover the wound with sterile dressing. hit, more brain movement causes the veins to stretch and • Visit a polyclinic/GP to change the dressing if it is wet, tear easily. Brain atrophy is usually seen in the elderly and dirty or loose. in patients who abuse alcohol. • Keep the wound and dressing dry and clean until the Patients who are more prone to bleeding, have blood sutures or staples are removed. clotting issues or are on long-term blood-thinning • You may wash your hair gently with mild shampoo a medication are also at higher risk. day after the sutures and staples are removed. • DO NOT scratch, massage or stretch the wound area. In rare cases, a CSDH can occur without any head injury • DO NOT apply anything to your wound unless Normal brain scan Blood and uid between and this may need further investigation. the brain and dura instructed by your doctor. Figure 1 Treating CSDH • DO NOT use hair products e.g. spray, gel, cream, dye Comparison of a normal brain scan and a patient with CSDH within the next three months post-surgery. Surgery is recommended if a patient's functions like • Visit a doctor immediately if the following occurs: Small, repeated bleeds of veins within the uid increases mobility are aected. º Persistent and increasing pain at the wound site. the amount of uid around the brain as time passes. º Fever of 38oC or higher. Symptoms usually occur weeks after the initial head injury. If functions are not aected, regular CT scans can be º Skin around the wound becomes red and swollen. ordered to monitor the condition. Signs of CSDH º Bleeding or foul-smelling discharge from the wound. During the surgery, a small opening or holes will be º Stitches give way. • Worsening headache created in the skull to drain uid. In some cases, a tube • Diculty in walking may be inserted for one to two days to continue draining • Confusion the uid post-surgery. • Weakness and/or numbness in arms, legs or face • Drowsiness • Seizure • Coma C HRONIC SUBDURAL H AEMORRHAGE.