What is your recommendation for treating an egg-sized subdural hematoma in a 20 year old patient with a 4 day history of vomiting and headache?

Subdural Hematoma: Many symptoms of subdural hematoma are related to the injury and diffuse damage head injury causes. Draining a small hemorrhage may not improve symptoms of headache and vomiting. Most small hematomas are acomodated in the cranium and resolve just like a bruise anywhere. The main reason to drain a bleed is if the pressure on the brain is not compensated. A neurosurgical consultation is indicated.

Depends: Surgical removal may be best option. If symptoms are pretty severe opening the head and removing the blood clot works. If symptoms minor a course of oral steroids and observation can be reasonable.