Head Injury and Coma Flashcards
What are the different types of head injury?
- Intracerebral
- Subarachnoid
- Subdural
- Epidural
How is Subdural Haemorrhage categorised?
- Acute
- Chronic
What is an Acute Subdural Haematoma (Haemorrhage)?
Fresh collection of blood between the dura mater and arachnoid mater
What are the common traumatic causes of a Subdural Haemorrhage?
- High speed injuries
- Acceleration-decelration
What are the investigations in suspected Subdural Haemorrhage?
=> First line - CT
- Crescent collection
- Hyperdense in comparison to rest of brain
- Midline shift and herniation
What is a Chronic Subdural Haemorrhage?
- Collection of blood in the subdural space that has been present for weeks or months
What are the risk factors of a Chronic Subdural Haemorrhage?
- Age (elderly)
- Alcoholics
- Those on anticoagulants
- Fragility in infants
- Predisposition of Bridging veins to bleed
What is the clinical presentation of a Chronic Subdural Haemorrhage?
- Confusion
- Reduced consciousness
- Neurological deficit
What are the investigations in suspected Chronic Subdural Haemorrhage?
=> CT
- Hypodense instead of hyperdense as in acute cases
What is the management of Subdural haemorrhages?
- Conservative management if small in size
- Surgical intervention with Burr holes if severe
What is an Epidural Haemorrhage?
- Collection of blood between skull and dura
What is the most common cause of an Epidural Haemorrhage?
Low impact trauma
Where is the blood most likely to collect in an Epidural Haemorrhage?
- In temporal region as thin skull a pterion overlies the middle meningeal artery
What is the clinical presentation of an Epidural Haemorrhage?
- Loss of consciousness, followed by a period where they regain consciousness only to lose it again
- Fixed dilated pupils
What are the investigations in suspected Epidural Haemorrhage?
=> First line - CT
- Biconvex
- Hypodense collection
