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Epidural and subdural Hematomas

Key Concepts:

Terms in this set (24)

epidural hematoma
a pool of blood trapped within the skull and the dura. arterial bleeding secondary to a tear of the middle menigeal artery or its branches
beginning of epidural hematoma
unconsciousness, followed by a lucid interval. minutes to hours later, signs of intracranial compression begin
s/s epidural hematoma
increasing headache, unconsciousness, siezures, ipsilateral pupil dilation, contralateral hemiparesis, hemilegia, + Babinski, decerbrate rigidity , respiratory failure
subdural hematoma
between the dura and arachnoid space. venous bleeding spreads slower. a tear or rupture of cortical veins
large acute subdural hematoma
progression of symptoms with in 24 - 48 hours rapid mortality. Burr hole, evacuate, SX
cause of subdural hematoma
may follow relatively mild head injury especially in someone on an anticoagulant
small and acute subdural hematoma
bleeding slower and clot becomes organized.
symptoms are not that severe. may treat with meds.
symptoms of large and acute subdural hematoma
loss of consciousness at time of injury, followed by return of consciousness.. sypmtoms come and go due to fluctuating areas related to the bleeding
later signs of large and acute subdural hematoma
headache, behavioral and personality changes, paresis or paralysis of extremities, pupilary signs, eventual brain stem compression possible
causes of subarachnoid hemorrage
is an arterial bleed between the arachnoid and pia. Is usually a from a cerebral artery aneurysm, trauma or associated with hypertension
symptoms of subarachnoid hemorrage
usually a sudden on set, headache, buchal rigidity, grossly bloody spinal fluid, focal signs
chronic subdural hematomas
s/s appear 3 weeks to several months later from a minor head injury because there is room for the ICP for a while
subacute subdural hematomas
s/s 2-3 days to 2-3 weeks after injury
minor head injury
could be from coagularpathies from anticoagulants, alcohol, liver injury of clotting factors, hypertension, aneryisms, neoplastic cancer,
brain atrophy
aging causes this and there is room for the swelling and the increased ICP and so symptoms occur later
S/S of chronic subdural hematomas
changes in LOC, N and V, headache, confusion,
compression on the pons
causes pin point pupils
compression on the occularmotor
dilated pupils
contralateral motor manifestation
opposite side of injury is effected
craniotomy
tx for acute subdural and epidural hematomas can ligate the vessels, remove blood and control bleeding
8 or less on glasgow coma scale
sever head injury and long term damage and disabilites result, the lower the scores the greater the impairment of LOC
comminurted fracture
must do a cranioplasty to go in and remove the pieces and reduce the pressure
tx for subacute and chronic subdural hematomas
must do craniotomy because Burr holes cannot work on the small bleeding vessels
depressed fractures
need cranioplasty to remove the fragments compressing on the bones
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