Subdural haematoma

Question 1

Definition

Answer 1

Bleeding between the dura and arachnoid mater caused by rupture of the bridging veins in the outermost meningeal layer

Question 2

Risk factors

Answer 2

Alcohol
Older
Coagulopathies
Trauma
Anticoagulant medication

Question 3

Symptoms

Answer 3

Depends on severity.
Can initially appear fine however as blood gathers it can cause N&V, neurological symptoms, confusion, loss of consciousness

Chronic: Over week/months - gait disturbance, confusion, hemiparesis

Question 4

Investigations

Answer 4

CT scan
Acute - bright crescent shape
Chronic - dark crescent shape

Both pass through sutures

Question 5

Management

Answer 5

Depends on severity
Acute - small or incidental can be observed conservatively. Surgical options include monitoring of ICP and decompressive craniectomy

Chronic - No symptoms can be managed conservatively. If neurological deficit or severe image findings then surgical decompression with burr holes is required

Question 6

Complications

Answer 6

Cerebral oedema
Herniation
IICP