5.10 Neurosurgical Intracranial Haemorrhage

Front 1

Classification of Primary Intracranial

haemorrhage

Back 1

Primary Intracranial Haemorrhage

a. Surgically correctable
i) Subdural
ii) Epidural
iii) Intracerebral haematoma

b. Not Surgically correctable
i) Nonhaemorrhagic cerebral contusions
ii) Diffuse axonal injury {DAI}
iii) Small intracranial haemorrhages

Front 2

Types of Secondary Intracranial Injuries

Back 2

1. Cerebral oedema
2. Delayed intracranial haematomas

Front 3

Which has the higher incidence:

Subdural or epidural haemorrhage?

Back 3

Subdural 40 % vs Epidural 10-15%

Front 4

The targetted approach to CT Head

interpretation in setting of head trauma- list

Back 4

Examine Brain + Subdural + Bone windows
1. Extra-axial blood [ SDH / EDH/ traumatic SAH]

2. Intraprenchymal blood [ contusion / haematoma ]

3. Midline shift
4. Ventricles
a) Compressed [mass effect ]
b) Enlarged [ CSF outflow obstruction]
5. Scalp swelling
6. Fractures
7. Pneumocephalus [ skull # sign]
8. Craniofacial sinuses [ blood or air/fluid level ]

Front 5

What are the 3 time-based categories of

Subdural haematoma ?

Back 5

1. Acute : < 3 days
2. Subacute : 3 days - 2 weeks
3. Chronic : > 2 weeks

Front 6

What are the Hounsfield units for

acute / subacute and chronic subdural haematoma ?

Back 6

Acute = Hyperdense = 50-90 HU

Subacute = isodense = 20-50 HU

Chronic = Hypodense = 5-10 HU