Subdural hematoma physical examination

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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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