Haemorrhage Flashcards
What structures line the brain? (3)
Dura mater
Arachnoid mater
Pia mater
What vessels are affected in an extradural haemorrhage?
Middle meningeal artery
What vessels are affected in a subdural haemorrhage?
Bridging veins
What vessels are affected in a subarachnoid haemorrhage?
Circle of Willis
What is a subarachnoid haemorrhage?
Spontaneous bleeding into the subarachnoid space
What is the main cause of subarachnoid haemorrhage?
Berry aneurysm rupture
What are the symptoms of subarachnoid haemorrhage? (4)
- Sudden onset ‘thunderclap’ headache
- Pain 10/10
- Vomiting
- Lowered consciousness/ coma
What are the signs of subarachnoid haemorrhage? (3)
- Kernig’s sign
- Brudzinksi’s sign
- Retinal bleeds
How would you investigate subarachnoid haemorrhage?
Urgent non-contrast CT head
How would you treat subarachnoid haemorrhage?
Neurosurgery immediately
What is a subdural haemorrhage?
Bleeding into subdural space due to rupture of bridging veins
What are the causes of subdural haemorrhage? (2)
RTA
Metastasis
What does haematoma formation lead to in a subdural haemorrhage?
Haematoma is hyperosmotic –> water is drawn in from the brain causing raised ICP and midline shift
What are the symptoms of subdural haemorrhage? (3)
- Fluctuating consciousness
- Headache
- Gradual deterioration
How would you investigate subdural haemorrhage?
Non-contrast CT head
How would a subdural haemorrhage appear on CT?
Crescent-shaped collection of blood
How would you manage subdural haemorrhage? (2)
Neurosurgeon - irrigation
IV mannitol
What is an extradural haemorrhage?
Rapid collection of blood in the extradural space due to middle meningeal artery rupture
What is the thinnest and therefore weakest part of the skull? Why is this important?
Pterion
Middle meningeal artery lies behind it
What is the cause of extradural haemorrhage?
Head injury –> skull fracture
What are the symptoms of extradural haemorrhage? (3)
- Decreased consciousness
- Signs of raised ICP
- LUCID INTERVAL, then unconscious
How would you investigate extradural haemorrhage?
Non-contrast CT head
How would an extradural haemorrhage appear on CT? (2)
Biconvex/ lentiform
Hyperdense haematoma
How would you manage extradural haemorrhage? (2)
Neurosurgeon - irrigation
IV mannitol
What are the differences between subdural and extradural haemorrhages? (2)
Subdural:
- Crosses the suture line
- Venous blood
Extradural:
- Doesn’t cross the suture line
- Arterial blood
