Subdural Haemorrhage

Question 1

What is the main type of injury associated with subdural haemorrhage?

Answer 1

Decelerating injury

Question 2

What does the decelerating injury do to cause bleeds?

Answer 2

Pulls bridging veins between cortex and venous sinuses apart

Question 3

Where does the bleed occur in subdural haemorrhage?

Answer 3

Between dura and arachnoid

Haematoma

Question 4

Risk factors of subdurals?

Answer 4

Fall risks

• Parkinsons
• Epilepsy

Reduced brain size

• Elderly
• Alzheimers

Question 5

Symptoms of subdural?

Answer 5

Fluctuating conscious level

Physical and intellectual deficit

HEADACHE

Unsteadiness

Question 6

Signs of subdural?

Answer 6

Raised ICP signs

Seizures (focal)

Localising symptoms occur a long time after injury

Question 7

DDx?

Answer 7

Stroke

Dementia

Space occupying lesions

Question 8

Investigations?

Answer 8

CT/MRI head

Question 9

What does the CT/MRI head show?

Answer 9

Crescent shaped clot
Unilateral

Midline shift

Question 10

Surgical treatment

Answer 10

Clot evacuation

• Burr hole
• Craniostomy (2nd line)

Question 11

Other treatment?

Answer 11

Investigate what caused the fall if that’s the aetiology

• Epileptic control
• Alcoholism