MCQ MAHE 2000 Medicine Answer 10

Chronic Subdural Hematoma

• Typically is the result of an apparently inconsequential traumatic incident that ruptures bridging veins à bleeding in the subdural space
• The small subdural clot does not get resorbed, but instead slowly expands à significant mass lesion (presumably due to small recurrent bleeds)
• Frequently occurs in elderly pts whose brain atrophy applies excessive stress on the bridging veins
• Typically found over convexities of the hemispheres and may be bilateral
• Clinical manifestations inc nonspecific symptoms such as headaches, drowsiness, and confusion
• The hematoma becomes encapsulated w/ granulation tissue derived from the dura mater. The tissue 1st covers the dural side of the clot and is known as the “outer membrane,” which attaches to the dura by fibrovascular strands (but is distinct from the dura). Fibroblasts from the outer membrane cover the inner side of the clot (arachnoidal side) and fully encapsulate it. This portion is more delicate and less vascular and is called the “inner membrane.” If the hematoma is resorbed, only the encapsulating membranes are left behind as hemosiderin stained “neomembranes” on the inner surface of the dura mater.
  

Category: MAHE 2000 MCQs