Subdural Hemorrhage | Anatomical Correlation Clinical | Features And Pathophysiology
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▬▬▬▬▬▬▬▬▬▬ Contents of this video ▬▬▬▬▬▬▬▬▬▬
0:00 Subdural Hemorrhage Anatomical Correlation Clinical Features And Pathophysiology.
1:39 Subdural Hemorrhage (SH): Anatomy of structures involved.
3:21 Cause of hemorrhage in the subdural area; the role of cerebral veins.
6:35 Pathology of SH; The floating brain; rupture of cerebral/bridging veins.
09:01 Deceleration injury; sudden shift between skull and brain.
11:28 Increased incidence of SH in elderly; Brain shrinkage. Alcoholics and Epileptics; Increased tendency to fall.
13:56 Comparison with Epidural hemorrhage.; CT and MRI imaging.
15:03 Clinical Presentations: Variable time between injury and onset of symptoms (insidious onset), unexplained fluctuating consciousness.
Summary; Epidural, Subdural, crescent-shaped, and biconvex lens; CT imaging, mechanism of injury.
Subdural Hemorrhage:
The subdural area is located between the Dural layer and the Arachnoid layer of the brain.
Cerebral Veins emanating from the cerebral hemispheres perforate through Pia, Arachnoid, and Dura mater to ultimately drain into the Dural venous sinuses and are the vessels injured and source of hematoma in SH.
The brain is "floating" in CSF in the subarachnoid space inside the skull and any sudden shift in its position/velocity can cause the brain to hit against the hard bony skull.
Such an injury can rupture the cerebral (or so-called "bridging veins") at the point where they are tightly held in the "Dural hole" of the skull.
Such a "Deceleration" injury can usually occur when a car brake at a very high speed but is also common due to a fall as often happens in elderly individuals, alcoholics, and epileptics, or maybe even a result of minor trauma to the back of the head.
The initial fall or minor trauma can be forgotten often and pathology can go on progressing for days or sometimes even years before symptoms arrive.
So, onset is often insidious and gradual and the patient presents with unexplained fluctuating levels of consciousness along with a history of falls.
A large unlocalized "loose" hematoma will appear in CT/MRI scan and is referred to as "crescent" shaped as opposed to the well-localized "biconvex" shaped Epidural Hemorrhage.
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