Subdural hematoma physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview[edit | edit source]

Common physical examination findings of subdural hematoma include decreased level of consciousness, mental status abnormalities, abnormal gait, evidence of intracranial hypertension (papilledema), hemiparesis, and Parkinson like symptoms.

Physical Examination[edit | edit source]

Appearance of the Patient[edit | edit source]

• Patients with subdural hematoma usually appear normal.

Vital Signs[edit | edit source]

• Fever (in infected subdural hematoma)
• Vital signs in patients with subdural hematoma is usually normal.

Skin[edit | edit source]

• Skin examination of patients with subdural hematoma is usually normal.

HEENT[edit | edit source]

• Abnormalities of the head including evidence of head trauma
• Extra-ocular movements are normal
• Pupils reactive to light and commodation
• Ophthalmoscopic exam may be abnormal with findings of papilledema (in case of intracranial hypertension)

Neck[edit | edit source]

• Neck examination of patients with subdural hematoma is usually normal

Lungs[edit | edit source]

• Pulmonary examination of patients with subdural hematoma is usually normal.

Heart[edit | edit source]

• Cardiovascular examination of patients with subdural hematoma is usually normal.

Abdomen[edit | edit source]

• Abdominal examination of patients with subdural hematoma is usually normal.

Back[edit | edit source]

• Back examination of patients with subdural hematoma is usually normal.

Genitourinary[edit | edit source]

• Genitourinary examination of patients with subdural hematoma is usually normal.

Neuromuscular[edit | edit source]

• Patient is usually oriented to persons, place, and time
• Altered mental status may be present in acute SDH
• Glasgow coma scale may be abnormal in acute SDH
• Abnormal gait may be present
• Negative Trendelenburg sign
• Unilateral/bilateral tremor may be present in chronic SDH mimicking Parkinson disease
• Bradykinesia may be present in chronic SDH mimicking Parkinson disease
• Absent dysdiadochokinesia (palm tapping test)
• Unilateral/bilateral upper/lower extremity weakness may be present in chronic SDH
• Unilateral/bilateral sensory loss in the upper/lower extremity may be present in chronic SDH

Extremities[edit | edit source]

• Extremities examination of patients with subdural hematoma is usually normal.

References[edit | edit source]

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