08-28-2014, 09:02 AM
q22
Ans: A
A) Acute subdural hematoma
(nbme cert)
Subdural Hematoma
SDHs are classified by the time to clinical presentation:
Acute SDHs are symptomatic within 24 hours after trauma. Patients with acute SDHs often have a decreased level of consciousness. Most patients with an SDH have a GCS (Glasgow) score less than 8. Approximately 12 to 38% of patients will have a lucid period at some point in their presentation. The overall mortality of patients who have an SDH and require surgical intervention is 40 to 60%.
A subacute SDH is symptomatic between 24 hours and 2 weeks after injury. It may appear hypodense or isodense on CT scans. Contrast increases detection of isodense lesions. Patients complain of a headache, altered mental status, or focal deficits. Most patients with subacute SDH require surgical evacuation of the lesion.
A chronic SDH becomes symptomatic 2 weeks or more after trauma. The signs and symptoms may be very subtle or nonspecific, but many patients demonstrate unilateral weakness or hemiparesis. Most report an altered level of consciousness, but some patients are unable to recall their head injury or describe only a minor injury.
Marx: Rosen's Emergency Medicine - Concepts and Clinical Practice, 8th ed.
Copyright © 2013 Saunders, An Imprint of Elsevier
Ans: A
A) Acute subdural hematoma
(nbme cert)
Subdural Hematoma
SDHs are classified by the time to clinical presentation:
Acute SDHs are symptomatic within 24 hours after trauma. Patients with acute SDHs often have a decreased level of consciousness. Most patients with an SDH have a GCS (Glasgow) score less than 8. Approximately 12 to 38% of patients will have a lucid period at some point in their presentation. The overall mortality of patients who have an SDH and require surgical intervention is 40 to 60%.
A subacute SDH is symptomatic between 24 hours and 2 weeks after injury. It may appear hypodense or isodense on CT scans. Contrast increases detection of isodense lesions. Patients complain of a headache, altered mental status, or focal deficits. Most patients with subacute SDH require surgical evacuation of the lesion.
A chronic SDH becomes symptomatic 2 weeks or more after trauma. The signs and symptoms may be very subtle or nonspecific, but many patients demonstrate unilateral weakness or hemiparesis. Most report an altered level of consciousness, but some patients are unable to recall their head injury or describe only a minor injury.
Marx: Rosen's Emergency Medicine - Concepts and Clinical Practice, 8th ed.
Copyright © 2013 Saunders, An Imprint of Elsevier