Science Medicine Neurology
A&E QUESTIONS AND ANSWERS
A subdural hematoma is a type of
bleeding in which a collection of
blood—usually associated with a
What is a subdural hematoma? traumatic brain injury—gathers
between the inner layer of the dura
mater and the arachnoid mater of
the meninges surrounding the
brain. It usually results from tears
in bridging veins that cross the
subdural space.
dura mater, arachnoid mater, pia mater
what are the three meningeal
layers
between the arachnoid matter and the pia matter
between which layers of the
meninges are the blood
vessels found
-HEADTRAUMA***
what are the causes of a
subdural haemorrhage
often from motor vehicle accident, falls, and assault
BRIDGING veins
what is the blood source in a
subdural haemorrhage
, Bleeding in a SDH occurs from
tearing of the bridging veins that
cross from the cortex to the dural
venous sinuses, which are
what is the pathophysiology of
vulnerable to deceleration injury.
subdural haemorrhage
This subsequently leads to
accumulation of blood between the
dura and arachnoid and results in
a gradual rise in intracranial
pressure (ICP). This can lead to
herniation and brainstem death if
left untreated.
-Scalp
-Skull
what are the layers of from the -Dura matter
skull to the brain tissue? -Arachnoid matter
-Pia matter
-Brain tissue
herniation and brainstem death if left untreated.
what is the most important
complication of a subdural
haemorrhage if left
untreated
increasing
age*
alcohol
what are the risk factors for excess
subdural haemorrhage epileptics (as prone to falls and head
injury) clotting disorders
taking anti-coagulants.
*Bridging veins are more vulnerable
to tear due to brain atrophy,
causing stretching of these veins
The gold-standard initial imaging
what is the preferred imaging modality* for a suspected SDH is a
modality for diagnosing non-contrast CT scan of the head
subdural hemorrhage
SDH should show a crescent-
shaped collection of blood over
one hemisphere, with or without
associated midline shift.
, Subdural haematomas will appear
differently on CT imaging,
what would you expect to
depending on the timing of
see when looking at a CT
presentation:
scan of someone with a -Acute - diffusely hyperdense
subdural hemorrhage (x4) -Subacute - heterogenously
hyperdense or isodense
-Chronic SDH - diffusely hypodense
An acute-on-chronic subdural
haematoma will present with areas
of hyperdensity within a
hypodense haematoma.
A&E QUESTIONS AND ANSWERS
A subdural hematoma is a type of
bleeding in which a collection of
blood—usually associated with a
What is a subdural hematoma? traumatic brain injury—gathers
between the inner layer of the dura
mater and the arachnoid mater of
the meninges surrounding the
brain. It usually results from tears
in bridging veins that cross the
subdural space.
dura mater, arachnoid mater, pia mater
what are the three meningeal
layers
between the arachnoid matter and the pia matter
between which layers of the
meninges are the blood
vessels found
-HEADTRAUMA***
what are the causes of a
subdural haemorrhage
often from motor vehicle accident, falls, and assault
BRIDGING veins
what is the blood source in a
subdural haemorrhage
, Bleeding in a SDH occurs from
tearing of the bridging veins that
cross from the cortex to the dural
venous sinuses, which are
what is the pathophysiology of
vulnerable to deceleration injury.
subdural haemorrhage
This subsequently leads to
accumulation of blood between the
dura and arachnoid and results in
a gradual rise in intracranial
pressure (ICP). This can lead to
herniation and brainstem death if
left untreated.
-Scalp
-Skull
what are the layers of from the -Dura matter
skull to the brain tissue? -Arachnoid matter
-Pia matter
-Brain tissue
herniation and brainstem death if left untreated.
what is the most important
complication of a subdural
haemorrhage if left
untreated
increasing
age*
alcohol
what are the risk factors for excess
subdural haemorrhage epileptics (as prone to falls and head
injury) clotting disorders
taking anti-coagulants.
*Bridging veins are more vulnerable
to tear due to brain atrophy,
causing stretching of these veins
The gold-standard initial imaging
what is the preferred imaging modality* for a suspected SDH is a
modality for diagnosing non-contrast CT scan of the head
subdural hemorrhage
SDH should show a crescent-
shaped collection of blood over
one hemisphere, with or without
associated midline shift.
, Subdural haematomas will appear
differently on CT imaging,
what would you expect to
depending on the timing of
see when looking at a CT
presentation:
scan of someone with a -Acute - diffusely hyperdense
subdural hemorrhage (x4) -Subacute - heterogenously
hyperdense or isodense
-Chronic SDH - diffusely hypodense
An acute-on-chronic subdural
haematoma will present with areas
of hyperdensity within a
hypodense haematoma.
