Subdural haemorrhage Flashcards
What is a subdural haematoma?
A subdural haematoma is a collection of blood deep to the dural layer of the meninges, classified as an ‘extra-axial’ or ‘extrinsic’ lesion. They can be unilateral or bilateral.
How are subdural haematomas classified by age?
Subdural haematomas can be classified as acute, subacute, or chronic.
What characterizes an acute subdural haematoma?
Symptoms usually develop within 48 hours of injury, characterized by rapid neurological deterioration.
What characterizes a subacute subdural haematoma?
Symptoms manifest within days to weeks post-injury, with a more gradual progression.
What characterizes a chronic subdural haematoma?
Common in the elderly, developing over weeks to months. Patients may not recall a specific head injury.
What is a typical presentation of a subdural haematoma?
A history of head trauma, a lucid interval followed by a gradual decline in consciousness, headache, confusion, and lethargy.
What are common neurological symptoms of a subdural haematoma?
Altered mental status, focal neurological deficits, headache, and seizures.
What are some physical examination findings in subdural haematoma?
Papilloedema, pupil changes, gait abnormalities, and hemiparesis or hemiplegia.
What behavioral and cognitive changes may occur in subdural haematoma?
Memory loss, personality changes, and cognitive impairment.
What are other associated features of subdural haematoma?
Nausea and vomiting, drowsiness, and signs of increased intracranial pressure.
What is an acute subdural haematoma caused by?
It is most commonly caused by high-impact trauma, often associated with other brain injuries.
What does CT imaging show for acute subdural haematomas?
A crescentic collection, hyperdense compared to the brain, with potential mass effect and midline shift.
How are small or incidental acute subdurals managed?
They can be observed conservatively.
What is a chronic subdural haematoma?
A collection of blood within the subdural space that has been present for weeks to months.
What causes chronic subdural haematomas?
Rupture of small bridging veins leading to slow bleeding, particularly in elderly and alcoholic patients.
What does CT imaging show for chronic subdural haematomas?
Crescentic in shape, hypodense compared to the brain, with mass effect.
How are small chronic subdural haematomas managed?
They can be managed conservatively if there are no neurological deficits.
When is surgical decompression required for chronic subdural haematomas?
If the patient is confused, has neurological deficits, or has severe imaging findings.
Subdural haematoma
Subdural haematoma
Subdural haematoma with significant midline shift
Subdural haematoma
