Which condition is characterized by vomiting, decreasing LOC, pupillary changes, unilateral weakness or paralysis, hypertension, changes in respirations, headaches, and seizures?

• A. Epidural hematoma
• B. Intracerebral hemorrhage
• C. Subdural hematoma
• D. Subarachnoid hemorrhage

Answer: (C)

This pattern points to a subdural hematoma, which is a venous bleed between the dura and arachnoid caused by tearing of bridging veins, often after a head injury. The slower, accumulating blood raises intracranial pressure over time, so symptoms tend to develop and worsen gradually. Vomiting and headache reflect the ICP rise, while decreasing level of consciousness and pupil changes signal brainstem involvement from pressure effects. Unilateral weakness or paralysis comes from mass effect on one side of the brain, and seizures can occur due to irritation of the cerebral cortex. Hypertension and changes in respiration are common responses to rising ICP as the body tries to maintain cerebral perfusion.

Epidural hematoma usually results from an arterial bleed and often follows a brief period of lucidity before rapid deterioration, with a pattern tied to a focal injury and rapid onset. Subarachnoid hemorrhage presents with a sudden “thunderclap” headache and meningismus rather than a progressive focal deficit, and intracerebral hemorrhage typically causes focal deficits and LOC changes from within brain tissue but the described progressive, multi-symptom picture after head trauma best fits a subdural bleed.