0071643192.pdf

TRAUMA

TABLE 3.4.

Intracranial Hematomas

TYPE OF

PATIENT

A

NATOMIC

LOCATION

CT F

INDINGS

COMMON

CAUSE

C

LASSIC

SYMPTOMS

Epidural

Most common in

Potential space between

Biconvex, football-shaped

Skull fracture with tear

Immediate LOC with a

young adults, rare

skull and dura mater

hematoma

of the middle

“lucid” period prior to

in the elderly

meningeal artery

deterioration (only occursin about 20% of patients)

Subdural

More risk for the

Space between dura

Crescent- or sickle-shaped

Acceleration–deceleration

Acute: Rapid LOC–l

ucid

elderly and

mater and arachnoid

hematoma

with tearing of the

period possible

alcoholics

bridging veins

Chronic: Altered MS andbehavior with gradualdecrease in consciousness

Subarachnoid

Any age group

Subarachnoid

Blood in the basilar

Acceleration–deceleration

Mild to moderate TBI with

following

cisterns and hemispheric

with tearing of the

meningeal signs and

blunt trauma

sulci and fissures

subarachnoid vessels

symptoms

Contusion/

Any age group

Usually anterior temporal

May be normal initially

Severe or penetrating

Symptoms range from

intracerebral

following

or posterior frontal

with delayed bleed

trauma; shaken-baby

normal to unconscious

hematoma

blunt trauma

lobe

syndrome

(Reproduced, with permission, from Tintinalli JE, Kelen GD, Stapczynski J

S.

Emergency Medicine

:A Comprehensive Study Guide

, 6th ed. New York: McGraw-Hill, 2

004:1568.)

Abbreviations: LOC

=

loss of consciousness; MS

=

mental state; TBI

=

traumatic brain injury.