Trauma and Haemorrhage

Question 1

Layers of the skull and brain, including spaces.

Answer 1

Scalp 
Skull - 
Periosteal dura mater 
Meningeal dura mater 
Arachnoid Mater 
Subarachnoid Space.
Pia Mater 
Cerebral cortex 

Extradural space - Potential opening between bone and dura mater.

Subdural space - a potential opening between dura mater and arachnoid mater. Caused by trauma etc..

In the spine, there is a space between the vertebrae and dura mater. - This is called epidural space.

Question 2

1. ) incidence of SAH?
2. ) Causes?
3. ) Risk Factors

Answer 2

1.) 9/100,000/y. Typical age 35-65.

2.) Spontaneous bleeding into the space.
Rupture of Berry/saccular aneurysms.

3.) Smoking, Alcohol misuse, BP, bleeding disorders,

Question 3

Common sites of Berry Aneurysm

Answer 3

Junction of Pos communicating artery with internal Carotid.
Anterior communicating with anterior cerebral artery
Bifurcation of middle cerebral artery.
Associations - Polycystic kidney disease, Coarctation of the aorta, Ehlers Danlos syndrome.

Question 4

Symptoms?

Answer 4

Sudden, devastating typically occipital headache.
Vomiting, collapse, seizures and coma.
Coma/drowsiness may last for days.