Subdural Haematoma

Question 1

Which brain bleed is commonest in traumatic head injury?

Answer 1

Subdural haematoma

Question 2

What is this a presentation of?
Elderly, anticoagulation, alcohol. Fluctuating consciousness, insidious physical/intellectual slowing, sleepiness, headache, personality change, nausea, vomiting. Previous minor injury a while ago.

Answer 2

Subdural haematoma

Question 3

What are the 3 A’s for vulnerable factors in a subdural haematoma?

Answer 3

1. Advanced age
2. Anticoagulation
3. Alcohol

Question 4

What are the signs of a subdural haematoma?

Answer 4

1. Raised ICP
2. Seizures
3. Focal neurology occurs late

Question 5

What is the pathophysiology of a subdural haematoma?

Answer 5

Bleeding from bridging veins between cortex and venous sinuses.

Question 6

What imaging is needed for a subdural haematoma and what will it show?

Answer 6

1. CT/MRI shows clot, midline shift of brain

2. Look for crescent/sickle shaped collection of blood over 1 hemisphere

Question 7

What is the management of a subdural haematoma?

Answer 7

1. Correct clotting abnormalities

2. Surgical management sometimes indicated