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nbme 5 - sweetiful
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07-03-2009, 01:42 PM
I think its epidural cuz,no signs at the time of injury followed by symptoms after 18hrs(lucid interval). A subdural hemorhage in a 75 yr old lady wont take that long to manifest itself. manifests as progressive headache right from the moment of fall and proceeds with pressure effects on the brain. Thats what i think.
07-03-2009, 01:44 PM
IT IS BBBBBBBB
BLOW TO THE BACK TOOK 18 HOURS FOR SYMPTOMS TO APPEAR(BRIDGING VEIN--CAUSE OF BEING LOW PRESSURED VESSEL SYMPT APPEAR GRADUALLY) SEMICONCIOUS,BLURRY V,WKNESS WHICH COULD ALSO BE SEEN IN CONCUSSION KEY WORD- "DIFFUSE HEMMORHAGE" THAT-- SPREAD ALONG THE SKULL-- GIVING " CRESCENT SHAPE" WHILE IN EPIDURAL H IT IS "LOCALIZED HEMORR"CAUSE CAN NOT EXTEND BEYOND THE SUTURE LINE AS THE DURA ADHERE TO SKULL AT THESE SUTURES, SO EPIDURAL H---- SPREAD TOWARDS THE BRAIN----GIVING "LENSE LIKE CONVEX SHAPE"(LENTIFORM). AND EPI H R CAUSE BY BLOW TO THE SIDE OF THE HEAD AND WILL HAVE "LUCID INTERVALE" AND CAN CAUSE UNCUS HERNIATION COMPRESSING THE CN III LEADING TO "FIXED DILATED PUPIL" .PT WILL ALSO HAVE SEVERE HEADACH CAUSE IT WILL CRUSH THE DURA BY COMPRESSING IT. SUBDURA H ARE MORE FREQUENT BUT EPIDUAL H R MORE SEVERE "SHAKEN-BABY SYND" IS ASSOCI: WITH SUBDURAL H(rotational forces).
07-03-2009, 01:55 PM
Subdula h----bridging vein---------------->"Diffuse hemorrhage"---crescent shape(concave)
epidural h---- middle meningeal artery-->"Localized h"----------------lense shape (convex)
07-03-2009, 02:12 PM
to fab
there is no lucid int in this pt. lucid int mean that the pt lose conciousness then REGAIN conciousness(FEEL LIKE PARTYING--just kidding) and then become unconcious again--death
07-03-2009, 02:18 PM
by the way Older peaople r more prone to get subdural h cause of brain atrophy
07-03-2009, 07:59 PM
she had no Sx at the time of injury but presents with blurry vision and left extremity weakness 18 hrs after the fall-----------it shows that he had the lucid interval
07-03-2009, 09:09 PM
I think its DDDD
The damage is manifested 18 hrs after the fall,hence there is a lucid interval..
07-03-2009, 09:15 PM
LUCID INTERVALE:
U GET HIT U LOSE CONCIOUSNESS---THEN RECOVER FOR MINUTES OR HOURS---THEN AGAIN LOSE CONCIOUSNESS. THE PERIOD OF RECOVERY BETWEEN TWO BOUTS OF UNCONCIOUSNESS IS LUCID INTERVALE. IN THE Qz SHE DIDN'T GET KNOCKED OFF AT THE TIME OF INJURY. |
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