Subdural Hematoma Medication

Updated: Jul 26, 2018
  • Author: Richard J Meagher, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Medication Summary

Although significant acute traumatic subdural hematoma requires surgical treatment, temporizing medical maneuvers can be preoperatively used to decrease intracranial pressure. Short-acting sedatives and paralytics should be used only when needed to facilitate adequate ventilation or when elevated intracranial pressure is suspected. If the patient exhibits signs of a herniation syndrome, administer mannitol 1 g/kg rapidly by intravenous (IV) push.


Osmotic Diuretics

Class Summary

These agents may help reduce intracranial pressure.

Mannitol (Osmitrol)

Mannitol may reduce subarachnoid space pressure by creating an osmotic gradient between the cerebrospinal fluid in the arachnoid space and the plasma. It is not for long-term use. Initially assess for adequate renal function in adults by administering a test dose of 200 mg/kg, given IV over 3-5 min; this should produce urine flow of at least 30-50 mL/h of urine over 2-3 hours.