Post evacuation of subdural hematoma

[tassefa]

   Hello,
       My dad had a crainotomy a couple of weeks ago because of a subdural hematoma. Is it normal post surgery to have severe headaches. He's also been experiencing a burning sensation all over his body. I know that subdural hematomas could reacummulate. Do you think these are signs of reaccumulation? should i take him to the nearest emergency room?

Thanks.

[tassefa]

Thanks so much for replying. I'll take him to the hospital tomorrow.

[midasrex]

Headaches post craniotomy for anything are very common. However after evacuation of a subdural haematoma they can be a sign of reaccumulation. If the headaches are stable or improving then you could sit it out for a few days but certainly if there are any other features such as loss of coordination of the other side, speech disturbance or confusion, then an urgent CT scan should be done. If his symptoms overall are improving then fine to wait and see but I would have a very low threshold for doing a CT scan. The problem is that often after evacuation of a subdural haematoma, especially in the elderly (maybe over 50-60) there will always be some residual subdural fluid after the operation. Retreatment therefore should be guided by the clinical progress (or lack thereof) of the patient not just the scans. However it is very useful if someone is having symptoms like this to have a scan, even if you wouldn't repeat the operation as they are too well, just so that if they are a bit worse in another few days or a week you have something to compare a new scan with, and then the treating neurosurgeon will have a handle on what's going on.

Hope this helps