Subdural Haemorrhage Flashcards
What is a subdural haemorrhage due to?
Damage to bridging veins between cortex and venous sinus
Who does a subdural haemorrhage normally occur in?
Elderly and alcoholics
Why are alcoholics and the elderly normally affected by a subdural haemorrhage?
Due to brain atrophy
What is an acute subdural haemorrhage?
Collection of fresh blood within the subdural space
What is an acute subdural haemorrhage due to?
High impact trauma
What can a large acute subdural haematoma do?
Push on the brain and cause midline shift or herniation.
What is a chronic subdural haemorrhage?
• Collection of blood within the subdural space
• Been present for weeks to months.
What can a subdural haemorrhage be due to?
Trauma that occurred months ago
Increased anticoagulant use
Bleeding disorder
Increased falls
Increasing age
Chronic alcohol use
How is a subdural haemorrhage diagnosed?
CT-scan
What is the management of a subdural haemorrhage?
Craniotomy
What might you see on a CT scan of a subdural haemorrhage?
Unilateral crescentic lesion in the right frontoparietal area.
Hypodense collection around the convexity of the brain that is not limited to suture lines (Chronic)
Can cause midline shift or herniation
What would you see on a CT scan if it was a chronic subdural haemorrhage?
Cerebral atrophy
Hypodense collection around the convexity of the brain that is not limited to suture lines
(looks like banana around outside)
Management of a chronic subdural haemorrhage?
Burr hole evacuation
Management of an acute subdural haemorrhage?
Decompressive craniectomy
What is the subdural space?
Between the dura and arachnoid layer
What is classed as an acute subdural haemorrhage?
Between 3 days and 3 weeks
What is classd as a chronic subdural haemorrhage?
More than 3 weeks
Is a chronic subdural haemorrhage limited by the suture line?
No
-neither is acute
How can a subdural haemorrhage occur in an infant?
Shaken baby syndrome
–They have fragile bridging veins
How can someone with a chronic subdural haemorrhage present?
Week to months progressive history of either confusion, reduced consciousness or neurological deficit
What is the management of a chronic subdural haemorrhage found incidentally and not causing any symptoms?
Manage conservatively- should dissolve with time
