Haematomas

Question 1

What is an extradural/epidural haematoma?

Answer 1

Collection of blood that is between the skull and dura

Question 2

What typically causes etradural haematomas?

Answer 2

Always trauma typically ‘low-impact’

e.g blow to head or fall

Question 3

What is the classical presentation of extradural haematomas?

Answer 3

• Patient who initially loses, briefly regains and then loses consciousness again
• fixed dilated pupil due to compression of parasympathetic fibres of 3rd cranial nerve

Question 4

What is a subdural haematoma?

Answer 4

Collection of blood deep to the dural layer, blood is not within the brain and is therefore an extrinsic lesion

Question 5

What is the difference between a an acute and chronic subdural haematoma?

Answer 5

Chronic has been there fore weeks or months, whereas acute has just happened

Question 6

What are the common causes of acute subdural haematomas?

Answer 6

*High-impact trauma

Question 7

What is the common causes of chronic subdural haematomas?

Answer 7

• Rupture of small bridging veins, causing slow bleeding

* Commonly seen in elderly and acoholic patients

Question 8

What is the presentation of an acute subdural haematoma?

Answer 8

*Ranges from incidental finding to severe coma and coning due to herniation

Question 9

What is the presentation of a chronic subdural haematoma?

Answer 9

*Several week to month progressive Hx of confusion, reduced consciousness or neurological deficit

Question 10

What investigation should be done for a an extradural or subdural haematoma?

Answer 10

CT head

Question 11

What should you follow if a patient has had a head injury?

Answer 11

NICE Head injury algorithm to determine whether they need a CT head