Which scenario is most consistent with an acute subdural hematoma?

Which scenario is most consistent with an acute subdural hematoma?

• A. Has a linear skull fracture crossing a major artery.
• B. Has focal symptoms of brain damage with no recollection of a head injury.
• C. Develops decreasing LOC and a headache within 48 hours of a head injury.
• D. Has an immediate loss of consciousness with a brief lucid interval followed by decreasing LOC.

Answer: (C)

Acute subdural hematoma typically results from tearing bridging veins, so blood collects between the dura and arachnoid slowly. Because it's venous bleeding, symptoms tend to develop over hours to a couple of days after the injury, with headache and a progressively worsening level of consciousness. That gradual decline within about 48 hours fits this scenario best. In contrast, an immediate loss of consciousness at the time of injury with a brief lucid interval followed by rapid deterioration is classic for an epidural hematoma, which is usually arterial and tends to worsen quickly after the initial event. A skull fracture crossing a major artery can point toward that arterial pattern. Focal symptoms without a clear timeline are less specific to this condition.

Acute subdural hematoma typically results from tearing bridging veins, so blood collects between the dura and arachnoid slowly. Because it's venous bleeding, symptoms tend to develop over hours to a couple of days after the injury, with headache and a progressively worsening level of consciousness. That gradual decline within about 48 hours fits this scenario best.

In contrast, an immediate loss of consciousness at the time of injury with a brief lucid interval followed by rapid deterioration is classic for an epidural hematoma, which is usually arterial and tends to worsen quickly after the initial event. A skull fracture crossing a major artery can point toward that arterial pattern. Focal symptoms without a clear timeline are less specific to this condition.