Subdural haemorrhage

Question 1

What is it?

Answer 1

Collection of blood in the subdural space due to rupture of a vein
Often post head injur

Question 2

What are the different types?

Answer 2

Acute
Subacute
Chronic

Question 3

What is acute subdural haematoma?

Answer 3

Normally as a result of acceleration deceleration injury
Co-existing other brain injury
In young people
No lucid interval before drop in GCS
Fixed dilated pupils

Question 4

What is chronic/subacute subdural haematoma?

Answer 4

Can be idiopathic or as a result of minor trauma
Common in elderly, alcoholics and if on anti-coagulation

Symptoms onset over days to months and can fluctuate

• decreased consciousness
• confusion
• drowsiness
• neurological deficits

Ultimately coma

Question 5

What investigations are needed?

Answer 5

CT head

• acute shows hyperdense crescent shape bleed
• can have midline shift if large
• chronic shows hypodense crescent shape

Neurosurgery input as may need decompression