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.

Sites
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.

Trauma
• 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 ?
There is no good place to suffer a subdural haemorrhage.
A post mortem found he died of an acute subdural haemorrhage caused by a cattle accident.
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.
Mr James said subsequent CT scans revealed the little girl, who cannot be named for legal reasons, had suffered subdural haemorrhage (bleeding on the brain), a fracture to the skull, fracture to the arm and fractured ribs.
There were blood spots on the baby's left eye and a CT scan showed bleeding, called a subdural haemorrhage, between the left side of the skull and brain.
Cause of death was officially recorded as cerebral oedema and subdural haemorrhage associated with second impact syndrome.
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).
Mr Summerscales lost two teeth in the attack and suffered a subdural haemorrhage - bleeding between his brain and his skull - the jury heard.
Hayley's death certificate says she died of an acute subdural haemorrhage - a leakage of blood from vessels on the underside of the layers covering the brain.
Miranda said: "Alan died from a subdural haemorrhage, severe retinal haemorrhage and haemorrhage of the lungs.
Mr Jones said one of the assaults on Shane led him to suffer a subdural haemorrhage in early August.