What is the classic presentation of a patient with a subdural hematoma?

The classic presentation of a subdural hematoma typically includes a recent head injury. Subdural hematomas often occur following trauma to the brain, with the potential for symptoms to develop over days to weeks after the injury, depending on whether the hematoma is acute or chronic.

In elderly patients, those on anticoagulants, or individuals with cerebral atrophy, even a minor head injury can predispose them to a subdural hematoma due to the brain having more space to move and potentially cause tearing of the bridging veins. This characteristic of having a well-documented or discernible event, like a fall or bump to the head, helps to establish a connection between the trauma and the subsequent development of the hematoma.

While gradual cognitive decline, focal neurological deficits, and seizures can also occur with subdural hematomas, they are not the hallmark initial presentation in the same way that a recent head injury is. These other symptoms are often the result of the pressure effects from the hematoma rather than indicative of the event that led to its formation.