The Subtle Brain Injury Older Adults Should Never Ignore

Chronic subdural hematoma, sometimes called a slow brain bleed, can start with a minor head impact and take weeks to surface. This is part of why it has become one of the most common and most missed brain conditions in adults over 65. A 2025 population study published in Stroke, an American Heart Association journal, estimated the U.S. incidence at roughly 17.3 cases per 100,000 people each year, with the rate climbing to about 355 per 100,000 in men 85 and older. 

This article serves as a resource for adult children and family caregivers who want to spot the warning signs early, understand why this injury is so often blamed on aging or dementia, and learn about how a minimally invasive treatment called middle meningeal artery (MMA) embolization with the top endovascular surgeons in West Hills is giving older patients a gentler road back than open brain surgery. 

What is a Chronic Subdural Hematoma? 

A chronic subdural hematoma (CSDH) is a slow pooling of blood that builds up between the brain and its outer covering, called the dura. The bleeding usually comes from tiny veins that run between those two layers. In older adults, those veins stretch out and grow more fragile as the brain naturally shrinks with age. This means a small bump, a missed step, or a quick stop in the car can be enough to nick one of them and cause bleeding.

Because the blood leaks out a drop at a time, the hematoma or collection of blood grows slowly and quietly. In fact, somewhere between 25% and 40% of patients cannot recall any head injury at all by the time their symptoms show up. That is what makes a CSDH so easy to miss in a parent or grandparent. 

What Are the Warning Signs of a Subdural Hematoma in Older Adults?

The warning signs of a subdural hematoma in older adults can be tricky to spot. Families usually notice small, frustrating changes that come on over several weeks. Things like: 

• Forgetting names
• New onset of confusion 
• Being unusually quiet 
• Shuffling when walking
• Leaning to one side
• Being more unsteady when standing or walking

Other symptoms include: 

• A nagging headache
• Mild nausea
• Weakness on one side of the body
• Slurred speech
• Unusually more sleepy 

The hard part is that these same symptoms look almost exactly like other conditions, like dementia, mini strokes, Parkinson's disease, or even depression. 

How Long After a Head Injury Can a Subdural Hematoma Develop?

The trickiest thing about a slow brain bleed is the gap between the fall and the first symptoms. Most cases develop two to eight weeks after the head impact, though sometimes it can be as much as a few months before symptoms appear. The risk of developing a CSDH goes up sharply for elderly adults who: 

• Take blood thinners or daily aspirin
• Have a history of falls
• Already had a subdural bleed before

A non-contrast CT scan of the head can show the blood clearly, and it takes only a few minutes to perform. This is the best test for an accurate diagnosis. 

Can a Chronic Subdural Hematoma Heal on Its Own?

A small CSDH that is not causing problems can sometimes be watched with follow-up scans, and the body may reabsorb a tiny amount of blood on its own. Most subdural hematomas that cause symptoms tend to keep oozing because the membrane that forms around the blood is full of fragile little vessels that leak right back into the same space. 

What is Middle Meningeal Artery (MMA) Embolization?

Middle meningeal artery embolization, often shortened to MMA embolization, is the best chronic subdural hematoma treatment in West Hills for elderly patients with CSDH. Instead of opening the skull with invasive brain surgery like burr holes or a traditional craniotomy, the best endovascular surgeons in West Hills make a small puncture in the wrist or groin and thread a thin, flexible tube called a catheter up through the blood vessels. Live X-ray imaging guides the catheter to the middle meningeal artery, which feeds the leaky membranes around the hematoma. A small amount of medical glue or tiny particles is then released to gently shut off that blood supply. With the source of the leak sealed, the body can finally reabsorb the old blood over the following weeks. 

Finding the Best Endovascular Surgeons in West Hills for Chronic Subdural Hematoma Treatment

The signs of a chronic subdural hematoma can be hard to spot and frustrating to deal with. At the Vascular and Neuroscience Institute, our team of expert endovascular specialists offers fast diagnosis and the most advanced treatment options, including minimally invasive middle meningeal artery embolization. We read imaging quickly, explain every reasonable option in plain language, and offer same-day care when necessary. 

Ready to get same-day care from the best endovascular surgeons in West Hills?