Subdural hemorrhage: Difference between revisions

Latest revision as of 22:16, 2 August 2020

Background

Epidemiology

Occurs in 5% of closed head injuries
- But up to 27% of severe head injuries

Pathophysiology

Rupture of bridging veins traversing subdural space
Acceleration contributes but not impact
Can occur without apparent trauma in the elderly or due to anticoagulation and a minor injury
Often shows underlying parenchymal damage
Chronic subdural bleeds are common in the elderly or in patients with shunts (related to over-draining)

Clinical Manifestations

Acute
- May be minor trauma that patient doesn't even remember
- More common with falls than motor vehicle collisions
Chronic
- Elderly patients
- Patients with shunts that are over-draining

Investigations

CT head shows crescent-shaped bleed
- Midline shift >1 cm is very worrying and requires urgent neurosurgery

@@ Line 1: / Line 1: @@
-== Epidemiology ==
+== Background ==
+===Epidemiology===
-* Occurs in 5% of closed head injuries
-** But up to 27% of severe head injuries
+*Occurs in 5% of closed head injuries
-== Etiology ==
+**But up to 27% of severe head injuries
+===Pathophysiology===
-* Rupture of bridging veins traversing subdural space
-* Acceleration contributes but not impact
-* Can occur without apparent trauma in the elderly or due to anticoagulation and a minor injury
-* Often shows underlying parenchymal damage
-* Chronic subdural bleeds are common in the elderly or in patients with shunts (related to over-draining)
+*Rupture of bridging veins traversing subdural space
-== Clinical Presentation ==
+*Acceleration contributes but not impact
+*Can occur without apparent trauma in the elderly or due to anticoagulation and a minor injury
+*Often shows underlying parenchymal damage
+*Chronic subdural bleeds are common in the elderly or in patients with shunts (related to over-draining)
+==Clinical Manifestations==
-* Acute
-** May be minor trauma that patient doesn't even remember
-** More common with falls than motor vehicle collisions
-* Chronic
-** Elderly patients
-** Patients with shunts that are over-draining
+*Acute
-== Investigations ==
+**May be minor trauma that patient doesn't even remember
+**More common with falls than motor vehicle collisions
+*Chronic
+**Elderly patients
+**Patients with shunts that are over-draining
+==Investigations==
-* CT head shows crescent-shaped bleed
-** Midline shift &gt;1 cm is very worrying and requires urgent neurosurgery
+*CT head shows crescent-shaped bleed
+**Midline shift &gt;1 cm is very worrying and requires urgent neurosurgery
 [[Category:Neurology]]