[indian]

Many friends confuse the two and CT scans of subdural and epirdural hemorrhages are common in Step 2 CK.

Click on these pics for higher resolution

These are pictures that I kept from my previous pediatric practice

 

[StepTaker]

Cerebral hemorrhages

Thanks einham23 for such a nice post
Let me explain the differences further and also some mention some other hemorrhages as they are all high yield in USMLE

Subdural Hemorrhage:

• Ruptured bridging veins
• Acute or chronic [example of chronic is child abuse]
• Crescentic shadow in CT scan [as seen above] which may show dark and white attenuation if old or new respectively [also seen in above CT scan]

Epidural Hemorrhage:

• Always traumatic [see the overlying subcutaneous hematoma in the image above] sometime skull fracture also seen, therefore usually acute history not chronic
• Caused by tear of dural arteries and most commonly middle meningeal artery
• Lucid interval is seen in the history
• Lenticular (biconvex) appearance in CT scan [see image above]

Basal Skull Fractures:

• Raccoon eyes: periorbital ecchymosis.
• CSF rhinorrhea
• Battle's sign: delayed ecchymosis over the mastoid process
• Hemotympanum: blood seen through the tympanic membrane

Subarachnoid Hemorrhage:

• "Worst headach of my life"
• Ruptured Berry aneurysm

Intracerebral Hemorrhage:

• Seen in Hypertension, Bleeding tendency, Cerebral amyloid angiopathy, Cocaine or amphetamines

 

[rasheed]

Lucid Interval

Lucid interval can be safely regarded as a buzzword for epidural hematoma

 

[dr.muhamad]

can u tell me exactly what is lucid interval???
is it like fainting and then getting back to live then faint again??
or just fainting after like some hours ?

 

[usmle2011]

Lucid Interval = Trauma => Pt. looses consciousness momentarily => Period of 1-48 hours (lucid Phase) before Patients neurological condition again deteriorates.
Hence Lucid interval is the period where the Pt. is asymptomatic.

 

[dr.muhamad]

Lucid Interval = Trauma => Pt. looses consciousness momentarily => Period of 1-48 hours (lucid Phase) before Patients neurological condition again deteriorates.
Hence Lucid interval is the period where the Pt. is asymptomatic.

so if he didnt lose the consciousness momentarily we should not consider it as lucid interval??
coz i guess this is important to differentiate between epi/sub-dural hemorrhage ?