Subdural Haematoma

Subdural Hematoma: Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90). Coma diabeticum (coma due to metabolic derailment in the setting of diabetes mellitus/sugar disease). Cardiovascular system (I00-I99). Apoplexy (stroke) Extracranial carotid stenosis – narrowing of the carotid artery outside the bony skull (extracranial). Extracerebral hemorrhage Epidural hematoma (synonyms: epidural hematoma; epidural hemorrhage; epidural hemorrhage) – bleeding into the epidural … Subdural Hematoma: Or something else? Differential Diagnosis

Subdural Hematoma: Complications

The following are the major diseases or complications that may be contributed to by subdural hematoma (SDH): Cardiovascular system (I00-I99) Recurrent hemorrhage (rebleeding). Psyche – nervous system (F00-F99; G00-G99) Anxiety disorders Depression Epileptic seizure (convulsive seizures) Cognitive impairment Neurological disorders

Subdural Hematoma: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: Assessment of consciousness using the Glasgow Coma Scale (GCS). General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Eyes [in acute subdural hematoma, pupils are different sizes when exposed to light (anisocoria)] Skin and mucous membranes Neck Extremities … Subdural Hematoma: Examination

Subdural Hematoma: Test and Diagnosis

Laboratory parameters of 1st order – obligatory laboratory tests. Small blood count [anemia due to intracranial hemorrhage] Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Coagulation parameters – activated partial thrombin plastin time (aPTT), anti-factor Xa activity (aXa), ecarin clotting time (ECT), INR (International Normalized Ratio), Quick value, thrombin time (TC). Laboratory … Subdural Hematoma: Test and Diagnosis

Subdural Hematoma: Drug Therapy

Therapeutic targets Seizure prevention Reduction of intracranial pressure Avoidance of secondary diseases and complications If necessary, normalization of blood clotting Therapy recommendations Seizure prophylaxis with carbamazepine For small hematoma (<10 mm) and mild symptoms: Glucocorticoids → dexamethasone → anti-inflammatory (anti-inflammatory) effect on the neomembrane. For hematoma reduction: Antifibrinolytic → tranexamic acid Used to normalize blood … Subdural Hematoma: Drug Therapy

Subdural Hematoma: Diagnostic Tests

Mandatory medical device diagnostics. Computed tomography of the skull (cranial CT or cCT). Magnetic resonance imaging of the skull (cranial MRI or cMRI) [not required in acute subdural hematoma; in chronic SDH, information is obtained on the approximate age of the hematoma].

Subdural Hematoma: Surgical Therapy

Indications for surgical therapy include: Pronounced neurologic symptoms Increased intracranial pressure (IPC). Fresh hemorrhage Seizures Space-occupying hematomas (bruises) Time management: In case of acute SDH, the intervention must be performed immediately In chronic SDH, the intervention may be performed later, depending on the symptoms Surgical procedures For smaller hematomas, a burr hole trephination is suitable … Subdural Hematoma: Surgical Therapy

Subdural Hematoma: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate subdural hematoma (SDH): Acute subdural hematoma-symptoms develop rapidly. Typical symptomatology of traumatic brain injury (TBI): Disturbances of consciousness up to unconsciousness Flexion and extension synergisms (due to the bleeding-in and intracranial pressure-induced deficits). Chronic subdural hematoma – symptomatology develops insidiously; initial hemorrhage starts small and enlarges over time … Subdural Hematoma: Symptoms, Complaints, Signs

Subdural Hematoma: Causes

Pathogenesis (disease development) The brain is enveloped by three densely packed meninges (meninges; layers of connective tissue). They protect and stabilize the brain. The dura mater is the outermost and thickest layer. It is directly adjacent to the skull. The middle meninges are called arachnoid mater (cobweb skin). The pia mater (delicate meninges) is the … Subdural Hematoma: Causes

Subdural Hematoma: Therapy

General measures Nicotine restriction (refraining from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Review of permanent medication due topossible effect on the existing disease. Anticoagulants Coumarins (phenprocoumon* (product names: Marcumar, Falithrom); warfarin (product names: Coumadin, Marevan); acenocoumarol (product name: Sintrom). Direct inhibitors of … Subdural Hematoma: Therapy