An acute subdural hematoma typically presents with which of the following within 24–48 hours after injury?

• A. Fever and neck stiffness.
• B. Decreasing LOC and headache within 24-48 hours.
• C. Seizure and unilateral weakness.
• D. Nausea and vomiting only.

Answer: (B)

The main idea is that an acute subdural hematoma after head trauma often produces a progressive decline in mental status along with a worsening headache as blood accumulates and raises intracranial pressure over the first day or two. This pattern reflects the venous bleed slowly expanding between the dura and the arachnoid, which compresses brain tissue and disrupts normal cerebral function. The decreasing level of consciousness signals that brain function is being affected, and the headache accompanies the rising pressure.

This combination—deteriorating alertness plus headache within 24–48 hours after injury—is more characteristic than fever with neck stiffness, which points to meningitis or another infection; seizures with unilateral weakness can occur but are not the most typical early presentation in this time frame; and nausea with vomiting alone is nonspecific and doesn’t specifically indicate an acute subdural hematoma.