http://www.med-ed.virginia.edu/courses/rad/headct/index.html
Acute subdural
Acute
Acute subdural
Extradural = epidural
haematoma with midline shift
Limited by
sutures
http://quizlet.com/40218512/rapid-review-pathology-chapter-26-nervous-system-and-special-sensory-disorders-images-flash-cards/
Chronic Subdural (weeks)
Subacute subdural
(days to weeks)
Extra dural on the patient’s right
Traumatic subarachnoid blood on the patient’s left (probable contra coup)
Spontaneous subarachnoid bleed ,
probably from aneurysm.
Get a CT angiogram while they are still in
CT
Intraventricular haemorrhage
Usually secondary to
hypertension
Other causes eg bleed into a
metatasis
Ring enhancing lesion
Ring enhancing lesions
MAGIC DR L
M: metastasisA: abscess
immunocompetent – usually bacterial direct head and neck vshaemotogenousImmunocompromised – toxoplasmosis, listeria, nocardia, aspergillusTravel Hx
G: glioblastoma multiformeI: infarct (subacute phase)C: contusionD: demyelinating diseaseR: radiation necrosis or resolving haematomaL: Lymphoma
Search for the source
Old lacunar infarct
eg thalamus, pons, internal capsule
Sensory and or motor deficits but no
change in LOC or comprehension
Day old cortical
ischaemic stroke
Eg whole MCA territory, dense paralysis and loss of sensation,
decreased LOC and comprehension
General care of the
acute head
Find the cause eg emboliTreat the cause eg infective, immunocompromise
NBM30 degrees head up
NormoxiaNormocapnia
Maintain hydrationLower BP if extreme (see next slides)
Exclude urinary retentionAvoid pressure areas
Hypertonic saline, bicarb or mannitol if coning and heading to theatre