subdural vs extradural haematoma

2 min read 16-03-2025

Meta Description: Explore the key differences between subdural and extradural hematomas, two serious types of brain bleeds. Learn about their causes, symptoms, diagnosis, and treatment options. This comprehensive guide clarifies the distinctions between these life-threatening conditions.

Introduction: Subdural and Extradural Hematomas – A Crucial Distinction

Subdural and extradural hematomas (EDH and SDH) are both serious types of brain bleeds resulting from head injuries. Understanding the differences between them is crucial for prompt diagnosis and effective treatment. This article will delve into the causes, symptoms, diagnosis, and treatment of each, highlighting the key distinctions that can mean the difference between life and death.

What is an Extradural Hematoma (EDH)?

An extradural hematoma, also known as an epidural hematoma, is a collection of blood that forms between the skull and the dura mater – the tough outer layer covering the brain.

Causes of Extradural Hematoma

EDHs are typically caused by arterial bleeding. This usually happens following a blow to the head that fractures the skull and tears the middle meningeal artery. The rapid bleeding leads to a build-up of pressure that compresses the brain.

Symptoms of Extradural Hematoma

Symptoms often present with a "lucid interval." This means the patient may experience a brief period of consciousness after the initial injury, before rapidly deteriorating. Other common symptoms include:

Severe headache
Dizziness
Nausea and vomiting
Seizures
Loss of consciousness
Pupil dilation

Diagnosis and Treatment of Extradural Hematoma

Diagnosis involves a CT scan of the head. Treatment requires immediate surgical intervention to evacuate the blood clot and relieve pressure on the brain. This usually involves craniotomy (surgical opening of the skull).

What is a Subdural Hematoma (SDH)?

A subdural hematoma is a collection of blood that forms between the dura mater and the arachnoid mater – the middle layer of the meninges.

Causes of Subdural Hematoma

SDHs are usually caused by venous bleeding. This often happens as a result of a less forceful head injury that tears bridging veins connecting the brain to the dura. Bleeding tends to be slower than in EDHs, but pressure can still build to dangerous levels.

Symptoms of Subdural Hematoma

Symptoms can be more insidious and develop gradually compared to EDHs. Symptoms include:

Headache (often worsening)
Drowsiness
Confusion
Memory problems
Weakness or paralysis on one side of the body
Seizures

Diagnosis and Treatment of Subdural Hematoma

Diagnosis, like EDHs, involves a CT scan. Treatment depends on the size and severity of the hematoma. Small, asymptomatic hematomas may be monitored. Larger hematomas usually require surgical evacuation or drainage via a craniotomy or burr hole.

Key Differences Between Subdural and Extradural Hematomas: A Comparison Table

Feature	Extradural Hematoma (EDH)	Subdural Hematoma (SDH)
Location	Between skull and dura mater	Between dura mater and arachnoid mater
Bleeding Source	Usually arterial (middle meningeal artery)	Usually venous (bridging veins)
Bleeding Rate	Rapid	Slower
Lucid Interval	Often present	Rarely present
Onset of Symptoms	Rapid	Gradual
Headache	Severe, often early symptom	Often worsening over time
Treatment	Usually requires immediate surgery	Varies depending on size and severity; may be monitored or surgically treated

When to Seek Immediate Medical Attention

Both EDHs and SDHs are medical emergencies. Seek immediate medical attention if you or someone you know experiences a head injury followed by any of the symptoms listed above. Early diagnosis and treatment are critical for improving outcomes.

Conclusion: Understanding the Nuances Saves Lives

While both subdural and extradural hematomas are serious conditions requiring prompt medical attention, understanding their distinct characteristics – from their location and cause to the nature of their symptoms and treatment – is crucial for effective management. Prompt diagnosis and treatment are key to minimizing long-term neurological damage. Always seek medical advice for any head injury, no matter how seemingly minor.