Question

Summarize the different types of hematomas that can occur in the brain.

• Describe epidural hematomas, subdural hematomas, and traumatic intracerebral hematomas.

Answer 1

Hematoma is a collection of blood trapped outside the blood vessels. Intracranial hematoma implies, the collection of blood between brain tissues or underneath the skull which increases pressure on the brain.

There are 4 common types of hematomas. They are:

• Subdural hematoma
• Epidural hematoma
• Subarachnoid hemorrhage
• Intracerebral hemorrhage

Epidural hematoma :

Epidural hematoma is also known as extradural hematoma (EDH). It occurs when blood is accumulated between the inner surface of the skull and the outer layer of the dura (endosteal layer). The main cause of EDH is head trauma and skull fracture. It is diagnosed by a head ct or mri. The main source of bleeding is commonly a torn middle meningeal artery. It is treated by performing a craniotomy in severe cases and burr holes in simpler cases.

Subdural hematoma:

Subdural hematoma is also known as Subdural hemorrhage (SDH). In this, blood accumulates in the subdural space, more specifically in the region between the dura and the arachnoid matter. The general cause of this is a severe blow to the head. Bleeding is generally due to the rupture of the bridging cortical veins and tearing of the arachnoid membrane which leads to the mixing of blood and CSF in the subdural space. It is treated by performing craniotomy. In less severe cases the patient is kept under observation.

Traumatic Intracerebral hematoma :

Traumatic Intracerebral hematoma is caused by a severe injury to the head. The contusion in this case is a mixture of blood and brain tissue. CT is performed to diagnose and often shows that the hematoma expands. Patients are kept under observation to prevent the increase of intracranial pressure (ICP). Treatment includes decompressive craniotomy, hypothermia, hyperoxygenation and administration of hypertonic saline. Coagulopathy is performed in case of excessive bleeding.