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Old 03-22-2011
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Neuro Subdural and Subarachnoid Bleeds

Hello study mates,

Could someone explain to me the difference between subdural and subarachnoid bleeds?

Thanks much!!!
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Old 03-22-2011
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Have a look at this
Subdural Epidural
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Old 03-22-2011
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Thanks Mary, that was helpful images for the subdural vs epidural.

What I'm confused about is the difference between subdural and subarachnoid.
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Old 03-22-2011
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Quote:
Originally Posted by healer2b View Post
Thanks Mary, that was helpful images for the subdural vs epidural.

What I'm confused about is the difference between subdural and subarachnoid.
Subdural hematoma occurs due to rupture of bridging veins, and can be acute or chronic. The acute form is more common after severe head trauma in younger persons, while the chronic form is more common after trivial head trauma in the elderly and in alcoholics. The former will present with acute compression signs, while the latter usually presents with non-specific symptoms like depression, forgetfulness, or dementia. On head CT, both forms will appear as crescent-shaped hyperdensities on one side of the skull.

Subarachnoid hemorrhage in adults most often occurs secondary to hypertension-induced rupture of a berry aneurysm. Another likely cause is rupture of an arteriovenous malformation (the most common cause of such bleeding in children). It presents with "the worst headache of my life" phrase. This kind of bleeding is also the most common cause of congenital non-obstructive hydrocephalus in premature babies. On head CT, it appears as diffuse hyperdensities over the brain and in the ventricular system. Lumbar puncture may also reveal xanthochromia (yellowish discoloration due to blood in CSF).
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Old 03-22-2011
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They are actually quite different in terms of clinical presentation and also radiologically as described by Haisook.

Typically SDH-an elderly patient with history of falls with fluctuating confusion.

Typically SAH-younger (than SDH group) hypertensive patient, with the worst headache ever.

I'm sure you'll be fine when you see these senarios in future.


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Originally Posted by healer2b View Post
Thanks Mary, that was helpful images for the subdural vs epidural.

What I'm confused about is the difference between subdural and subarachnoid.
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Old 03-22-2011
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An acute SDH appears on the noncontrast head CT scan as a crescent-shaped hyperdense area between the inner table of the skull and the surface of the cerebral hemisphere


The location of blood within the subarachnoid space correlates directly with the location of the aneurysm in 70% of cases. In general, blood localized to the basal cisterns, the sylvian fissure, or the intrahemispheric fissure indicates rupture of a saccular aneurysm. Blood found lying over the convexities or within the superficial parenchyma of the brain often is indicative of AVM or mycotic aneurysm rupture.
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