subdural vs epidural haematoma

Daniel Parker

3 min read

·

16-03-2025

1

0

Share

Meta Description: Explore the crucial differences between subdural and epidural hematomas, including their causes, symptoms, diagnosis, and treatment. Learn how to recognize the signs of these life-threatening conditions. (158 characters)

Subdural and epidural hematomas are both serious types of bleeding in the brain, but they differ significantly in their location, cause, and progression. Understanding these differences is crucial for timely diagnosis and treatment, as both conditions can be life-threatening.

What is a Subdural Hematoma?

A subdural hematoma (SDH) occurs when bleeding happens between the dura mater (the tough outer layer of the brain covering) and the arachnoid mater (the middle layer). This space normally contains a small amount of fluid. SDHs are often caused by a rupture of bridging veins that cross the subdural space.

These veins are more susceptible to tearing during a head injury, even a seemingly minor one. The bleeding typically develops slowly, resulting in symptoms that may not appear immediately.

Causes of Subdural Hematoma

• Head injuries: Falls, motor vehicle accidents, or any trauma to the head are common causes. Even relatively minor impacts can cause a SDH, particularly in older adults or those with conditions that increase bleeding risk (e.g., anticoagulant use).
• Spontaneous rupture: In rare cases, a subdural hematoma can occur spontaneously, without any apparent trauma. This is more likely in individuals with pre-existing conditions affecting blood vessels.

Symptoms of Subdural Hematoma

The symptoms of a SDH can vary depending on the size and location of the hematoma and how quickly it develops.

• Headache: Often described as severe and worsening.
• Drowsiness or confusion: Difficulty concentrating or remembering things.
• Nausea and vomiting: These symptoms can be accompanied by dizziness.
• Seizures: Sudden, uncontrolled electrical activity in the brain.
• Weakness or paralysis: On one side of the body.
• Unequal pupil size: This indicates pressure on the brain.

What is an Epidural Hematoma?

An epidural hematoma (EDH) is a collection of blood that forms between the dura mater and the skull. This space typically contains only a small amount of tissue fluid. EDHs are usually caused by arterial bleeding, meaning that blood flows into the space under high pressure. The most common cause is a tear in the middle meningeal artery.

Causes of Epidural Hematoma

• Head injuries: Typically caused by a blow to the head, often from a direct impact such as a fall or a traffic accident. The injury causes a tear in the artery, leading to rapid bleeding.

Symptoms of Epidural Hematoma

Epidural hematomas tend to present with a more dramatic and rapid onset of symptoms compared to subdural hematomas because of the high-pressure arterial bleeding.

• Brief loss of consciousness (LOC): Followed by a lucid interval (a period of seeming recovery) before symptoms worsen. This is a classic, but not always present, sign of an EDH.
• Severe headache: Intense and quickly worsening.
• Drowsiness and confusion: Similar to SDH, but usually progressing much faster.
• Nausea and vomiting: Can accompany the other symptoms.
• Dilated pupil: One pupil may become larger than the other, indicating increasing intracranial pressure.
• Seizures: As with SDH, seizures are a possible symptom.
• Weakness or paralysis: On one side of the body.

Subdural vs. Epidural Hematoma: A Comparison

Diagnosis and Treatment

Both SDHs and EDHs are typically diagnosed using a CT scan of the brain. This imaging technique quickly reveals the location and extent of the bleeding. An MRI may be used for further evaluation.

Treatment usually involves surgical intervention to evacuate the hematoma and relieve pressure on the brain. This may involve craniotomy (opening the skull) or burr holes (small holes drilled into the skull). In some cases, less invasive techniques may be used. The severity of the hematoma and the patient's overall condition will determine the best course of treatment. Post-operative care is crucial, often involving monitoring for complications.

When to Seek Medical Attention

Any head injury that results in significant symptoms, such as persistent headache, confusion, vomiting, or LOC, requires immediate medical attention. Early diagnosis and treatment of subdural and epidural hematomas are essential for improving outcomes and preventing permanent disability or death. Don't hesitate to seek medical help immediately if you suspect a head injury.

Disclaimer: This information is intended for educational purposes only and should not be considered medical advice. Always consult a medical professional for diagnosis and treatment of any health condition.