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Cases involving subdural haemorrhages are notoriously difficult to defend and, quite frankly, to understand, but as theproud recipient of a 'C' at A-level Biology, I can’t think of anyone more qualified to write about such a thing.
The anatomy bit
The brain is covered by three membranes. The first is a thin film called thepia mater, which is impervious to fluid. Above that is thesubarachnoid space topped by thearachnoid mater, with thefinal thicker dura mater just below theskull. Passing between these layers are blood vessels. Recently, in an effort at trying to explain to me in words of as few syllables as possible, a neurosurgeon, Peter Richards, used a pictorial analogy. A bemused judge and equally bemused lawyers were invited to consider thebrain as a sausage, thepia as thesausage skin, thearachnoid as thecling film around thesausage and thedura as thesandwich bag around that. He didn’t go so far, but I suppose theskull would be thelunchbox and presumably therucksack it is put in would be thehat?
The injury bit
In ordinary life there is no reason for there to be fluid in thesubdural space. The subarachnoid space contains clear cerebrospinal fluid, and again, in ordinary life, no blood. The existence of fluid ie blood in thesubdural space is almost always due to some form of infection or trauma. We, as lawyers, will only become involved where thesuggestion is that a child has suffered some inflicted trauma. This will have shown up on an MRI or CT scan as fluid in thesubdural or subarachnoid space. This has happened because theblood vessels which cross thelayers have been torn as a result of theapplication of force in what is often described as a 'to and fro' fashion. This causes blood to leak into thesubdural or subarachnoid layers and will almost always have had an impact on the
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