subdural haemorrhage

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subdural haematoma

Subdural haematoma, aetiology
Acute SDH
Caused by tearing of communicating veins which traverse the subdural space, or more rarely the sinuses, due to a change of velocity of the head (acceleration or deceleration), often with some rotational movement. The site of original haemorrhage is not usually identified.

Lateral surface of a cerebral hemisphere, often in a parasagittal position. After blunt impact, the SDH may not be situated under the site of impact. The blood may move following accumulation.

Chronic SDH
May expand due to rebleeding or osmosis of CSF into the centre of the heamatoma; it may also be resorbed or stay the same size. The colour changes from dark red to brown between days 5 and 12.
Cellular infiltration occurs within a few hours; a neomembrane formed adjacent to dura which is a few cells thick in 4 days. Fibroblasts from the membrane enter the clot at 5–8 days.

Day 15: Membrane is present under the clot.
1–3 months: Hyaline appearance to membrane.
6–12 months: Thick, fibrous membrane, like dura.

• Rapid acceleration/deceleration (with tearing of  dural bridging veins);
• Minor trauma in setting of cerebral atrophy;
• Birth trauma in neonates.

Dural neoplasms
• Meningiomas
• Metastases

Abnormal haemostasis.

subdural haemorrhage

Bleeding between the DURA MATER and the underlying ARACHNOID MATER. See SUBDURAL HAEMATOMA.
References in periodicals archive ?
Arvind Kumar et al, noted that from his study Subdural haemorrhage 89%, followed by subarachnoid haemorrhage 72% extramural 20.
There is no good place to suffer a subdural haemorrhage.
He has undergone three neurological operations since suffering a subdural haemorrhage after walking off the course and into the Goodwood weighing room following a fall from Lanican Lane during the running of an amateur riders' race on August 26.
One recent report describes subdural haemorrhage [6] arising from a fall at night during REM sleep behaviour disorder nocturnal motor activity.
A postmortem found he died of an acute subdural haemorrhage and a pathologist said there was "no sign of an assault".
The inquest heard the medical cause of death was brain swelling and subdural haemorrhage.
Subdural haemorrhage was the most common type of intracranial haemorrhage.
Acute subdural haemorrhage (aSDH) secondary to an aneurysmal bleed is a surgical emergency that requires urgent decision making.
Subdural haemorrhage following endoscopic third ventriculostomy.
Yesterday at Bradford Coroner's Court, the court heard how the mother-of-one was admitted to hospital where her family were told she had suffered an acute subdural haemorrhage.
A CT brain scan showed a right frontal intracerebral haemorrhage with some associated mass effect, but no midline shift and a small left occipital subdural haemorrhage (Figure 1).