Subdural hematoma stroke

Hemorrhagic stroke is a result of bleeding into the brain and other spaces within the central nervous system and includes subarachnoid hemorrhage, intracerebral hemorrhage, and subdural hematomas. 

Hemorrhagic strokes account for 12% of strokes and include subarachnoid hemorrhage, intracerebral hemorrhage, and subdural hematomas. Subarachnoid hemorrhage may result from trauma or rupture of an intracranial aneurysm or arteriovenous malformation. Intracerebral hemorrhage occurs when a ruptured blood vessel within the brain parenchyma causes formation of a hematoma. Subdural hematomas are most often caused by trauma. 

CNS disorders (brain tumor, strokes, head injuries, subdural hematoma, multiple sclerosis, systemic lupus erythematosus, temporal lobe seizures, Huntington s disease)... 

Misdiagnosis of stroke is not uncommon and it is well recognized that nonvascular conditions such as brain tumor, subdural hematoma and cerebral abscess may mimic cerebral ischemia (Groch et al. 1960). Misdiagnosis occurs if details regarding past history are lacking. This may be because the patient is aphasic, comatose or demented. A careful patient... 

Although intracranial mass lesions such as cerebral abscess, subdural hematoma and brain tumors do not usually present with acute stroke-like symptom onset, 6% of brain tumor patients presented with symptoms of less than 24-h duration (Snyder et al. 1993). Misdiagnosis of these cases is easily prevented by CT or MRI and should not play a major role nowadays. 

Any injury in the days and weeks before ischemic stroke or TIA onset is important and may not be spontaneously volunteered by the patient particularly where this occurred some time previously. A head or neck injury might have caused a chronic subdural hematoma (highly unlikely if more than three months previously) or carotid or vertebral dissection (Ch. 6). 

Of 378 patients with a clinical diagnosis of definite minor stroke, there were nine (2.4% 95% Cl, 1.3-4.5) with non-vascular pathology (six intracranial tumors, one demyelination, one arachnoid cyst, one subdural hematoma). Possible minor stroke was diagnosed in 36, and non-vascular pathology was identified in five (13.9% 95% Cl, 6.1-28.7), all of whom had intracranial tumors. 

Strokes 414, 436 Stupor 369, 370 Subdural hematoma 642 Subependymal cysts 217, 223 Subileus 593, 600-602 Sudden death 63, 94, 310, 315-319, 321... 

Comment. Other possibilities for his presenting symptoms inclnde small strokes (including mnlti-infarct dementia), chronic subdural hematoma, low-grade tumor metastases, B12 deficiency, atypical Alzheimer disease, prion disease, and chronic fungal or other infection. 

Suggested Alternatives for Differential Diagnosis Meningitis, basilar artery blood clots (thrombosis), cardioembolic stroke, cavernous sinus syndromes, cerebral venous blood clots (thrombosis), confusional states and acute memory disorders, epileptic and epileptiform encephalopathies, febrile seizures, haemophilus meningitis, intracranial hemorrhage, leptomeningeal carcinomatosis, subdural pus (empyema), or bruise (hematoma). 

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