Subdural Hematoma
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December 21, 2023
3 min read
Subdural Hematoma
- Acute: < 72 hours
- Subacute: 3-7 days
- Chronic : > 7 days
Indications for Surgical Evacuation
- Volume of bleed >30 ml
- >10mm thickness of bleed
- >5 mm midline shift regardless of GCS score
- If GCS <9
- If GCS drops by >2 points between time of event and time of evaluation
- If GCS < 9, needs ICP monitoring and if ICP > 20mm, evacuation needed
- If pupillary asymmetry present, evacuate.
Medical management:
- Mannitol 0.25 gm/kg IV q 6 h
- D/C if Serum measured osmolarity > 320 or Serum Sodium > 150.
- Typically you can use it for upto 48 hours.