Which option indicates an acute subdural hematoma?

Which option indicates an acute subdural hematoma?

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

Answer: (C)

Acute subdural hematoma typically presents with a progressive decline in mental status and headache that develops within hours to a few days after head trauma, because venous bleeding from bridging veins gradually increases intracranial pressure. The option describing decreasing level of consciousness and a headache within 48 hours fits this pattern, making it the best choice. It reflects the common, evolving neurologic deterioration seen in acute subdural hematoma as the blood slowly accumulates. In contrast, an immediate loss of consciousness followed by a brief lucid interval is more characteristic of an epidural hematoma, where arterial bleeding causes a rapid surge in pressure after a transient period of apparent recovery. A description involving a skull fracture crossing a major artery is more aligned with injuries predisposing to arterial bleeds, again more typical of epidural scenarios. A presentation of focal brain-damage symptoms with no clear head injury history is not specific to acute subdural hematoma.

Acute subdural hematoma typically presents with a progressive decline in mental status and headache that develops within hours to a few days after head trauma, because venous bleeding from bridging veins gradually increases intracranial pressure.

The option describing decreasing level of consciousness and a headache within 48 hours fits this pattern, making it the best choice. It reflects the common, evolving neurologic deterioration seen in acute subdural hematoma as the blood slowly accumulates.

In contrast, an immediate loss of consciousness followed by a brief lucid interval is more characteristic of an epidural hematoma, where arterial bleeding causes a rapid surge in pressure after a transient period of apparent recovery. A description involving a skull fracture crossing a major artery is more aligned with injuries predisposing to arterial bleeds, again more typical of epidural scenarios. A presentation of focal brain-damage symptoms with no clear head injury history is not specific to acute subdural hematoma.