Post on 11-Jan-2016
description
Intracranial Haemorrhages
Sanjaya AdikariDepartment of Anatomy
Intracranial Haemorrhages
Intracerebral Extracerebral
Extradural (epidural) haemorrhage
Arterial bleeding
Bleeding from middle meningeal artery
Following a hard blow to the head
Blood collects between dura mata and skull
Extradural haematoma is formed
Haematoma biconvex in shape
Brain compression and death if not evacuated
Middle meningeal artery
Subdural haematoma
Venous bleeding
Bleeding due to tearing of cerebral veins as they enter superior sagittal sinus
Following a blow to the head that jerks the brain inside the cranial cavity
Incident is usually long before and forgotten
Blood collects between dura mata and arachnoid mater
Subdural haematoma is sickle shaped
Subarachnoid haemorrhage
Usually arterial bleeding
Bleeding from internal carotid and circle of willis arteries
Due to arterial aneurysms (ruptured due to high blood pressure)
Blood collects in the subarachnoid space
CSF gets mixed with blood----Xanthochromasia
Severe headache and neck stiffness due to meningeal irritation
Sequence of events following head injury and raised intracranial pressure
Initial concussion
Lucid interval
Drowsiness
Pupils initially constrict then dilated and fixed
Pulse initially may increase then reduce
BP increases with reducing pulse (cushing reflex)
Should monitor BP, pulse, respiration and pupils
Cerebral herniation through tentorium cerebelli
Uncus
Question
• An individual received a fracture of the left temporal bone due to an accident. Subsequently, he developed extradural haemorrhage. Few hours later, he became drowsy and confused. An examination of his eyes showed a dilated left pupil that was non-reactive to light. His BP was high and pulse rate was reduced.
• 1. Name the vessel involved in producing bleeding in this case.
• 2. Explain the reasons for the following observations
2.1. Dilated, non-reactive pupil of left eye2.2. Reduced pulse rate