Emergency Medical Technician (EMT) Basic Certification Practice Exam

Which of the following is a symptom of a subdural hematoma?

1. Pupils mid-sized and fixed

2. Expanding arterial bleeding

3. Slowly expanding venous bleed

4. Decerebrate posturing

The correct answer is: Slowly expanding venous bleed

A subdural hematoma is typically caused by a venous bleed that occurs between the brain and its outer covering, specifically the dura mater. This type of hematoma is often the result of trauma, leading to tearing of veins in the brain as it moves within the skull, especially in cases of acceleration-deceleration injury or blunt trauma. Slowly expanding venous bleeds are characteristic of subdural hematomas because venous injuries lead to a gradual accumulation of blood. Symptoms may develop over days to weeks, depending on the size and rate of bleeding, which is in contrast to arterial bleeding that tends to be more acute and causes symptoms to manifest rapidly. In contrast, mid-sized and fixed pupils, expanding arterial bleeding, and decerebrate posturing are not typical for a subdural hematoma. Fixed pupils can indicate severe brain injury or increased intracranial pressure, while expanding arterial bleeding typically refers to epidural hematomas, which develop more quickly. Decerebrate posturing is a sign of significant brain dysfunction, which may occur in severe brain injuries but is not specific to subdural hematomas alone. This highlights how the gradual nature of venous bleeding aligns with the clinical presentation of subdural hematomas, reinforcing the