Intracranial bleeds

Question 1

Subdural haemorrhage: who gets them?

Answer 1

elderly and alcoholic

Question 2

Extradural haemorrhage: who gets them?

Answer 2

Patients presenting w/ history of ongoing headache following a fracture to the temporal bone after trauma head injury

Question 3

What is a subdural haemorrhage?

Answer 3

A bleed in the space between the dura mater and arachnoid mater

(a bleed between the arachnoid and the pia mater is subarachnoid haemorrhage)

Question 4

What is an extradural haemorrhage?

Answer 4

a bleed where the blood collects in the potential space between skull and dura mater. usually due to middle meningeal artery rupture

Question 5

What is the order of the meningeal layers from inner most to outer most?

Answer 5

(brain)
pia mater
arachnoid mater
dura mater
(skull)

Question 6

What are the main principles of management for intracranial bleeds?

Answer 6

1. immediate CT for diagnosis
2. FBC and clotting is checked
3. admit to specialist care team e.g. stroke team
4. correct consciousness level
5. correct HTN and clotting abnormalities

Question 7

How does a subdural haemorrhage appear on CT?

Answer 7

like a cresent

Question 8

How does an extradural haemorrhage appear on CT?

Answer 8

like a bulge, large in size and around the temporal region

Question 9

GCS score is out of …?

Answer 9

15

Question 10

GCS eye scoring

Answer 10

spontaneous = 4
speech = 3
pain = 2
none = 1

Question 11

GCS verbal scoring

Answer 11

orientated = 5
confused = 4
inappropriate words = 3
incomprehensible = 2
none = 1

Question 12

GCS motor response scoring

Answer 12

obeys commands = 6
localises pain = 5
normal flexion = 4
abnormal flexion = 3
extends = 2
none = 1