Subdural Haemorrhage Flashcards
What is a Subdural Haematoma?
Collection of blood in in subdural space following rupture of a vein
Usually post head injury, can occur spontaneously
What are the two main types of subdural haematoma?
Acute
Subacute/spontaneous
When do acute subdural haematomas typically occur?
Occur in severe-acceleration deceleration head injury, often w/ co-existing brain damage
Young pts
How do acute subdural haematomas typically present?
Dilated pupil
Non lucid
Decreased GCS
What are the key elements of managing acute subdural haematomas?
ABCDE resus
Craniotomy & early evacuation of clot
ICU admission w/ intracranial pressure monitoring
What are the common complications of acute subdural haematomas?
Epilepsy
Permanent neurological disability
High mortality
When do subacute/spontaneous subdural haematomas typically occur?
Spontaneously/after minor trauma
Can be bilateral
What are the risk factors for subacute/spontaneous subdural haematomas?
Age (cortical atrophy stretches brittle veins)
Alcohol abuse
Coagulopathies
What are the sx/signs of raised ICP?
Headache Drowsiness Confusion Focal neurological signs Stupor/coma
How should subacute/spontaneous subdural haemorrhage be managed?
Liaise w/ neurosurgeon
Chronic subdural haemorrhage may resolve spontaneously
What imaging modality is used to assess subdural haemorrhage?
CT
What is the appearance of an acute subdural haematoma on CT?
Crescenteric shape w/ increased density, conforming to contour of skull
Midline shift
Ventricular compression
What is the apperance of a chronic subdural haematoma on CT?
Blood becomes radiolucent (dark), assumes a lentiform shape (sim to extradural)
