Cerebral bleeds

Mr Balboa had been out at Crown Casino and had an altercation on the roulette tables, reported to be punched in the temple. He briefly lost consciousness at the scene for approximately 30 seconds but regained full awareness shortly after, appearing alert and oriented. Approximately two hours later, he developed a worsening headache, nausea, and one episode of vomiting, followed by increasing drowsiness and confusion. Now presenting to you at the emergency department. On examination, his Glasgow Coma Scale (GCS) was 11 (E3 V3 M5), his right pupil was dilated and sluggishly reactive to light, and he had left-sided motor weakness (3/5), raising concern for a traumatic intracranial bleed.

• Acute sub dural

• Extra dural

• Sub arachnoid

• Chronic sub dural

Mr Balboa has a CT. What features are indicative of his extra dural bleed.

• Limited by the suture line

• Biconcave lens shaped

• Crescent moon shaped

• Can show hyperdensity in ventricles

Mr McQueen is racing his car and collides with a pole. He presents to emergency with head ache, slurred speech and confusion. What are the likely CT scan images in this particular situation.

• crescent shaped

• low density area

• hyperdense in ventricles only

• hyper dense area

Mr Attenborough is a 99 year old gentleman who is presenting with a 4 month history of increasing headaches and difficulty concerntrating after his recent trip to the galapagos island to search for turtles where he had a minor trip and fall on some rocky outcrops. He reports he still has been taking his anticoagulants. What is his likely diagnosis if he has a bleed?

• Epidural

• Acute subdural

• chronic sub dural

• sub arachnoid

Mr Attenborough has a CT of his brain, what would we expect to see in this case?

• Hyperdense area

• Low density area

• Nothing

• Images of turtles

Mr Stalin is a 75 yo male, presenting to emergency department with a sudden onset, worst headache that you could ever imagine after exerting himself in the bedroom (vacuuming). What kind of bleed is most likely?

• extra dural

• sub dural

• subarachnoid

• submandibular

Mr Stalin has a CT, what would we expect to see

• hyperdense areas that dont cross suture lines

• hyperdense ventricles

• star fish pattern

• hyperdense areas in the sylvian fissues