Pediatric emergency medicine trisk 3649 3649

FIGURE 113.2 Epidural hematoma. A head computed tomography scan shows the
classic biconvex hyperdensity of an epidural hematoma.

Subarachnoid hemorrhage involves traumatic injury to the vessels
supplying the pia matter. As the cerebral subarachnoid space extends to the
spinal subarachnoid, the accumulation of blood may be extensive and layers
along the bony surface.
There are no specific criteria for surgical intervention with cerebral
hemorrhage. In the patient who is deteriorating because of increased ICP,
care may require escalation from temporizing measures, as described above,
to evacuation of the clot, and finally to decompressive craniectomy.

CONCUSSION
CLINICAL PEARLS AND PITFALLS