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Subdural Epidural

14419 Views 5 Replies 5 Participants Last post by  dr.muhamad
Many friends confuse the two and CT scans of subdural and epirdural hemorrhages are common in Step 2 CK.

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Circle Font Medical radiography Event Science
Medical Service Circle Monochrome Monochrome photography

These are pictures that I kept from my previous pediatric practice
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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
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