Subdural Hematoma - No diving?

[Tizzy]

Patient complained of headache for 2 weeks. The diagnosis, CT found isodense subdural hematoma 8mm right frontal midline shift & no evidence of intracerebral bleeding. No specific head trauma. Emergency doctor sent patient home with Tylenol 3 & instructions not to engage in high risk activities for minimum 1 year. Now, I know this should be a no brainer (pun intended) but really 1 year? Does this seem reasonable? Patient will seek specialist advice but was just wondering has anyone had any experience with this type of thing?
Thanks for any input.

 

[TSandM]

8mm shift is a pretty big subdural. No history of trauma? Is the patient on anticoagulants? It would be extremely strange to have something like that happen spontaneously.

One of the biggest risks after subdurals is seizures. Since seizures underwater are likely to be lethal, I can certainly see why someone would be advised to avoid diving for a full year.

But if I were the patient, I'd be worrying a lot about why this happened, because until you have an explanation for it, you don't know how likely it is to happen again, or how to prevent it. I think I'd follow up with a neurologist or neurosurgeon and ask about further imaging studies.

 

[Tizzy]

No anticoagulants. Yes, we are seeking a consult with a neurologist. A follow up CT has been scheduled. Unfortunately when you live in the land of goverment run medicine you are at their mercy. It's called take a number & get in line. I was told it would be 8 months before I could get an appointment with a neurologist. I am not giving up yet, but just casting my net to see if any one has had or heard tell of anyone in a similiar situation. Thanks for you interest.

 

[rigdiver]

My suggestion is to come South to the US where CT scans and neuro specilaists are more numerous. Time is, well proven to equal loss of tissue.
Bill R.N.

 

[TSandM]

I wouldn't settle for another simple CT. I'd want a CT or MRI angio. You have to try to figure out where the blood came from.

 

[Tizzy]

Managed to get an appointment with a neurologist today, I was lucky, there was a cancellation. MRI has been scheduled. The doctor seems to think that this bleed may be related to horseback riding (no I did not fall off) I have been riding for years. He seems to think that the action of sitting trot may have caused it, not convinced but there you go. He seems to think I will be fine just need to give it time to heal. I hope so. In the mean time DAN has Emailed with some good news. As long as I have suffered no neurological effects and the hematoma resolves itself and with a doctors approval I may be able to dive again. It may take time but I will just have to be patient. Thank you everybody for your input.

 

[KidK9]

An MRI should be demanded at this point. No diving for a year makes sense...and even then, I personally wouldnt clear a patient until I did another MRI after a year.