Medicine

Question 1

Types of brain bleed.

Answer 1

Extradural (epidural) haematoma:

Bleeding into the space between the dura mater and the skull.

Often results from acceleration-deceleration trauma or a blow to the side of the head.

Occur in the temporal region where skull fractures cause a rupture of the middle meningeal artery.

Features of raised intracranial pressure.
Some patients may exhibit a lucid interval.

CONVEX ON CT

Subdural haematoma:

Bleeding into the outermost meningeal layer.

Most commonly occur around the frontal and parietal lobes - bridging veins.

Risk factors include old age, alcoholism and anticoagulation.

Slower onset of symptoms than a epidural haematoma.

CONCAVE ON CT (CRESCENT MOON)

Question 2

How do you assess GCS?

Answer 2

Motor response

6. Obeys commands
7. Localises to pain
8. Withdraws from pain
9. Abnormal flexion to pain (decorticate posture)
10. Extending to pain
11. None

Verbal response

5. Orientated
6. Confused
7. Words
8. Sounds
9. None

Eye opening

4. Spontaneous
5. To speech
6. To pain
7. None