deck_3167258 Flashcards
Define an extra-axial haemorrhage
Bleeding occurs within the skull but outside the brain tissue
What are the different types of extra-axial haemorrhage?
SubarachniodExtraduralSubdural
Define subarachnoid bleeding
Spontaneous arterial bleeding into the subarachnoid space. Thunderclap headache, vomiting, coma and neck stiffness are common features
Causes of subarachnoid haemorrhage
Saccular aneurysms - develop on circle of willisArteriovenous malformations Trauma
What will you see on imaging with a subarachnoid haemorrhage?
Intraventricular or subarachoid blood
DDX for subarachnoid bleed
Severe migraineBacterial meningitis?
Treatment for subarachnoid haemorrhage
Immediate bed rest Referral for neurosurgery
Describe a subdural haematoma
Accumulation of venous blood in subdural splace following the rupture of a bridging vein- usually after a head injury- can be spontaneous in elderly and alcoholics due to atrophy of neural tissue
Presentation of subdural haematoma
Initial traumaPotential loss of conciousnessConfusionFocal deficits (hemiparesis, sensory loss)Can go onto to fall into a coma
Management of subdural haematoma
Immediate imaging- lens shaped appearanceReferred for urgent neurosurgery
Describe an extradural haematoma
Rapid accumulation of blood outside the duraUsually due to damage to the middle meningeal artery after trauma to temporal region (fractured pterion)
Presentation of extradural haematoma
Loss of consciousnessFollowed by a lucid interval Followed by a progressive hemiparesis and stupor
What can occur with an extradural haematoma?
Rapid tentorial or tonsillar herniationIpsilateral pupil dilationEventual bilateral fixed pupil dilation, tetraplegia and respiratory arrest will then occur.
What is seen on imaging of an extradural haematoma?
Lemon shaped bleed
