Brain bleeds

Question 1

Extradural Haematoma

• how does it occur?
• commonly due to rupture of what?
• known as what syndrome?

Answer 1

Blunt force e.g. cricket ball to head

Commonly due to rupture of middle meningeal
Artery

“Talk and die” Syndrome - patient will be fine just sitting and talking -then drop dead later that day

Question 2

Subdural Haemorrhage

• rupture of what?
• commonly due to what force in which group of people?
• onset?
• small ones: Tx?
• large ones: Tx?

Answer 2

Caused by rupture of bridging veins

Common in low force head injury in
Elderly and alcoholics

More chronic in onset, sometimes
Found incidentally

Small ones can heal over time and be
Managed conservatively

Acute and larger subdurals are treated
Surgically by craniotomy or burr hole excavation

Question 3

Subarachnoid Haemorrhage

• presents as?
• rupture of?
• signs?
• associated with?
• if -ve CT - can do LP: how does it look on LP?

Answer 3

thunderclap headache

Burst blood vessel, usually an aneurysm or
Arteriovenous malformation (AVM)

• meningeal signs but NO fever
• Association with polycystic kidney disease and berry aneurysms

Xanthochromia (yellow colour)