Critical care - Extradural Haematoma

Question 1

CT Head

Answer 1

extradural

Axial CT imaging of the head demonstrating the characteristic appearance of a extradural haemorrhage:

A biconvex, lozenge shaped area of increased density.

Haematoma extension is limited by the adhesion of the dura to the skull.

?A midline shift with compression of the left ventricle is also

An urgent neurosurgical opinion is required

Commonly results from trauma to the side of the head with subsequent rupture of the middle meningeal artery

Treament (after CT) involves complete haematoma evacuation through a horse shoe craniotomy flap.

In case of rapid clinical deterioration, temporary relief may be provided by means of a burr hole and craniotomy positioned centrally over the haematoma.

Question 2

CT Head

Answer 2

extradural

https: //geekymedics.com/extradural-haematoma-overview/
https: //mypastest.pastest.com/Secure/Mrcsb/SpotDiagnosis/4

Axial CT imaging of the head demonstrating the characteristic appearance of a extradural haemorrhage:

A biconvex, lozenge shaped area of increased density.

Haematoma extension is limited by the adhesion of the dura to the skull.

?A midline shift with compression of the left ventricle is also

An urgent neurosurgical opinion is required

Commonly results from trauma to the side of the head with subsequent rupture of the middle meningeal artery

Treament (after CT) involves complete haematoma evacuation through a horse shoe craniotomy flap.

Question 3

Crit care 24 male falls off ladder

constituents of GCS? EYES

Answer 3

EYES

1. No eye opening
2. Eye opening in response to pain. (i.e., pressure to fingernail bed or sternal rub)
3. Eyes opening to speech
4. Eyes opening spontaneously

Question 4

GCS drops - management?

Answer 4

Repeat A t o E assessment

GCS <8 - Anaesthetics Airway support

Question 5

Crit care 24 male falls off ladder

constituents of GCS? Verbal Response

Answer 5

1. No verbal response
2. Incomprehensible sounds (such as moaning)
3. Inappropriate words
4. Confused speech
5. Orientated speech

Question 6

Crit care 24 male falls off ladder

constituents of GCS? Verbal Response

Answer 6

1. No verbal response
2. Incomprehensible sounds (such as moaning)
3. Inappropriate words
4. Confused speech
5. Orientated speech

Question 7

Cause of secondary GCS drop in Extradural?

Answer 7

Enlarging haematoma - elevation of ICP

• ipsilateral pupil dilation (secondary to uncal herniation and oculomotor nerve compression)
• cushings reflex - elevated BP, bradycardia and irregular breathing
• eventually CNS depression and death

Question 8

Crit care 24 male falls off ladder

constituents of GCS? Verbal Response

Answer 8

1. No verbal response
2. Incomprehensible sounds (such as moaning)
3. Inappropriate words
4. Confused speech
5. Orientated speech

https://www.openanesthesia.org/glasgow_coma_scale_definition/

Question 9

Crit care 24 male falls off ladder

constituents of GCS? Motor Response

Answer 9

1. No motor response
2. Extension to pain
3. Abnormal flexion to pain
4. Withdrawal to pain
5. Localizes to pain
6. Obeys commands

https://www.openanesthesia.org/glasgow_coma_scale_definition/