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Veins of Head and Neck

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The blood drainage from the head and neck is primarily managed by three pairs of veins: the external jugular, internal jugular, and vertebral veins. The external jugular veins drain superficial scalp and face structures, passing over the sternocleidomastoid muscles to empty into the subclavian veins.
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Related Experiment Video

Updated: Jan 15, 2026

Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model

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Headaches in chronic subdural hematoma: Does size matter?

Crystal X Wang¹, James Feghali¹, Jiwon Moon¹

¹Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Clinical Neurology and Neurosurgery

|October 14, 2025

Summary

Headache in chronic subdural hematoma (cSDH) is linked to larger hematoma thickness. A threshold of 12.5 mm hematoma thickness may indicate headache development in cSDH patients.

Keywords:

Chronic subdural hematoma Headache Risk factors

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Last Updated: Jan 15, 2026

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Published on: July 28, 2018

Area of Science:

Neurosurgery
Neurology
Radiology

Background:

Chronic subdural hematoma (cSDH) commonly causes headaches, but the exact relationship between hematoma size and headache severity is not fully understood.
Understanding this relationship is crucial for diagnosing and managing cSDH patients effectively.

Purpose of the Study:

To investigate the association between total hematoma size and headache presentation in patients with cSDH.
To identify a critical hematoma thickness threshold for the development of headaches in cSDH.

Main Methods:

Retrospective review of adult cSDH patients diagnosed between January 2023 and June 2025.
Exclusion of patients with Glasgow Coma Score (GCS) < 14 or history of ventricular shunt.
Analysis of demographic data, hematoma characteristics, headache presence, and GCS using logistic regression and ROC analysis to determine the relationship between hematoma thickness and headache.

Main Results:

Out of 341 eligible patients, 49.6% presented with headache.
Patients with headache exhibited significantly greater hematoma thickness (18.3 mm vs. 15.1 mm) and more frequent midline shift.
Younger age and increased hematoma thickness were independently associated with headache (OR=1.03, p=0.029).
A hematoma thickness threshold of 12.5 mm was identified for headache development (AUC=0.596, p=0.002).

Conclusions:

Headache in cSDH is multifactorial, with younger age and greater hematoma thickness being independent predictors.
A critical hematoma thickness of 12.5 mm may serve as a threshold for clinically apparent headaches due to stretching of pain-sensitive structures.