8/2/2023 0 Comments Subdural hematoma blown pupil![]() (Rarely) Cerebrospinal fluid leak into the spine, or after shunt surgery. Blood thinners – Aspirin, clopidogrel, warfarin, NOACs or other medications. Minor head injury – May not be noticed or remembered by the patient. CausesĬhronic Subdural Haematoma (usually from tearing of a small superficial vein on the brain)… The fluid in CSDH ranges from a ‘thick motor oil’ consistency to a thinner yellow fluid, and can sometimes have clear water-like appearance. This occurs due to the body’s natural processes to dissolve the fresh clot, and in so doing, the break-down contents of the clot / haematoma accumulate and attract more fluid into the subdural space, which in turn can cause more pressure and compression of the brain. Chronic Subdural HaematomaĬhronic Subdural Haematoma (CSDH) is a haematoma that has been present for at least 5 – 7 days, in which the thick consistency of ASDH gradually evolves to become more ‘fluid-like’. Medications for EDH / ASDH are usually not beneficial to remove the clot. This flap will be returned to the patient with a separate operation in a delayed fashion several months later once the brain swelling has subsided (‘cranioplasty’). Sometimes, the skull flap is not replaced immediately and kept secure in a bone bank (‘craniectomy’). Since the clot in EDH or ASDH is thick in consistency, a large opening is required to relieve the pressure on the brain. This is usually performed through a craniotomy, in which a section of skull is opened with a medical saw (‘craniotome’) to gain access to remove the haematoma. If the volume of the haematoma is large enough, or there is sufficient pressure on the brain, surgical removal of the haematoma is required. Patients with EDH / ASDH will require admission into hospital for at least 24 hours to be observed. In patients who are taking blood-thinning medications, additional blood tests may be performed to determine whether treatments to reverse the blood-thinners are necessary. In EDH, there is usually an associated skull fracture. This will determine the presence of EDH or ASDH, the volume of the haematoma and the amount of pressure and compression of the underlying brain. ![]() The definitive test to diagnose is a CT scan performed within the Emergency Department. Both conditions require urgent medical attention. ![]() ASDH may have similar symptoms, but without the ‘lucid interval’. This progression is a sign of haematoma expansion and worsening pressure and compression of the brain. Blood thinners, such as aspirin, clopidogrel, warfarin, NOAC’s or other medications.Ĭlassical symptoms of an EDH include brief loss of consciousness, followed by a ‘lucid interval’, then development of progressive headaches, weakness, numbness and increasing drowsiness, and dilated pupil in the eye.CausesĮxtradural haematoma (usually from a torn artery in the skull)…Īcute subdural haematoma (usually from an artery or vein on the surface of the brain)… Both extradural and acute subdural haematoma are serious conditions that can cause compression of the underlying brain, and usually are a result of significant head trauma, which may be associated with a brief episode of loss of consciousness. Extradural haematoma (EDH) is a blood clot that forms on the outside of the natural covering of the brain (‘dura mater’), while acute subdural haematoma (ASDH) refers to a blood clot on the inner surface of the dura that appears within the first few days of head injury. A haematoma is a medical term for blood clot, which forms as a result of bleeding into an organ or cavity.
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