12. Traumatic intracranial bleeding

Question 1

Types of intracranial bleeding

Answer 1

Epidural, subdural, subarachnoid, intraparenchymal

Question 2

Subdural hemorrhage what and where

Answer 2

Subdural space: bw. dura mater and arachnoid. Head trauma leading to rupture of bridging veins.

Question 3

Epidural hematoma

Answer 3

Temporal bone trauma leading to rupture of middle meningeal artery

Question 4

Define intracranial bleeding

Answer 4

Any bleeding within the skull

Question 5

Symptoms of epidural hematoma

Answer 5

• Headache (severe)
• Loss of consciousness, then a period of alertness, then rapid deterioration back to unconsciousness.
• Confusion.
• Dizziness.
• Drowsiness or altered level of alertness.
  Nausea or vomiting.

Question 6

Subdural hematoma CT findings

Answer 6

Crescent lesion which can cross the suture lines

Question 7

Subarachnoid hemorrhage

Answer 7

Traumatic brain injury or berry aneurysm rupture. Arterial bleeding into subarachnoid space. Giving severe headache

Question 8

Contusion

Answer 8

Traumatic brain injury (coup or counter-coup injuries). Multiple microhemorrhages leaking into brain tissue.

Question 9

Symptoms of subdural hematoma

Answer 9

Slow, gradual progression of symptoms.
- Focal neurological signs (esp. limb weakness)
- Signs of incr. ICP: headache, papilledema, nausea
- Detoriation of conciousness
- Brain shift

Question 10

Causes of subdural hematoma

Answer 10

MVA, shaken baby syndrome

Question 11

Complication of subdural hematoma and symptoms

Answer 11

Uncal herniation: Ipsilateral CN III, contralateral weakness, signs of PCA stroke