Subdural haematona after clipping?

Hi all

Hope you’re all well!

I had an unruptured aneurysm clipped about 6 months ago.

I’ve got a question about a CTA result I got today. I’ve been having tension headaches for about a week (maybe 4-6/10 severity) and I got a scan that found:

  • “a small extra-axial haematoma and small volume pneumocephalus”

This was near the incision site. It’s also referred to in the report as a:

  • “small subdural haematoma deep to the left pterional craniotomy”

Finally, the report notes it results in “minor sulcal effacement”

Can I please check if anyone else has had this post clipping or has an idea how serious it is?

I’ll follow up with my Neuro of course but interested if this is a standard part of recovery.

Thanks :slight_smile:

Hey Curious1,

Standard? I don’t think I’d call it standard, but for some of us it does occur. So, here’s a bit of a breakdown:
“a small extra-axial haematoma” This is a small collection of blood (haematoma) between the brain and the skull (extra-axial).
"and small volume pneumocephalus” This is a small collection of air (pneumo) within the skull. I have developed ‘hydrocephalus’ also known as ‘Water on the brain’ or a collection of water (Cerebral Spinal Fluid (CSF)) within the skull.

“small subdural haematoma deep to the left pterional craniotomy”
The brain itself has layers of tissue on the outside called ‘The dura mater’. When they say ‘subdural’ haematoma they mean under the dura. “left pterional” on the left, near the temple.

“minor sulcal effacement” in VERY basic terms, the fluid (CSF) within our skull flows through areas known as the ventricles, when they speak of ‘sulcal effacement’ it’s often pressure (from the hematoma) altering the ventricles/fluid flow. There is not much space within our skull and a hematoma will naturally put pressure on the brain structures and therefore alter the flow of CSF.
I hope this explains some of the medical terminology/jargon.

Considering you’ve had a craniotomy and clipping, none of this is unusual. These are all issues I have had to deal with post craniotomy and so long as the hematoma does not get bigger, I would suggest it’s not too serious. Now, in saying that, I am not a Dr, just a patient, so I’d strongly support your plans to follow up with a neuro.

Merl from the Modsupport Team

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Hi Merl

I honestly can’t thank you enough - so helpful to have someone break it down into layman’s terms like that.

Really appreciate it :slight_smile:

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Not a problem Curious1.
These medicos LOVE using their jargon which is often so confusing (and often conflicting too). I have found that if I see 4 differing neuros I can end up with 4 differing opinions because the scans/pictures can often be ‘open to interpretation’. The radiologists report explains what he sees in the images ie hematoma, but the surgeon also takes into consideration the procedure he has performed to come to a more holistic response.

Merl from the Modsupport Team.

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