Management of subdural haematoma: a practical guide

Acute and chronic subdural haematomas are two common but distinct conditions, increasingly encountered by non-neurosurgical medical teams. Although each carries a significant mortality, there have been recent advances in the care of these, typically in older, frail patients. Challenges often arise from cardiovascular or thrombotic disease and with the need for antithrombotic medication. When considering when or whether to restart antithrombotic agents, patients need nuanced, individualised decisions to balance the competing risks of thrombosis against that of progressive or recurrent haemorrhage. Middle meningeal artery embolisation is increasingly used both as an adjunctive intervention and a stand-alone treatment for chronic subdural haematoma. The evidence defining its role is evolving but it appears safe and effective and will likely be increasingly used.