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Brain Education: Cerebral Vasculature

Intracranial Hemorrhage

Types

• Subdural hematoma: Bleeding between the brain tissue and the dura mater (a tough fibrous layer of tissue between the brain and skull) is called a subdural hematoma. The stretching and tearing of “bridging veins” between the brain and dura mater causes this type of bleeding. A subdural hematoma may be acute, developing suddenly after the injury, or chronic, slowly accumulating after injury. Chronic subdural hematoma is more common in the elderly whose bridging veins are often brittle and stretched and can more easily begin to slowly bleed after minor injuries. They are potentially serious and often require surgery.


• Epidural hematoma: Bleeding between the dura mater and the skull bone is an epidural hematoma. These occur when arteries are cut. Injury in the temple area is a common cause. Epidural hematoma is potentially serious and often requires surgery.


• Intraparenchymal hemorrhage/cerebral contusion: These terms describe bleeding into the brain tissue itself. A contusion is like a bruise to the brain tissue and usually requires observation for complications such as brain swelling. An intraparenchymal hemorrhage is bleeding within the brain tissue. Minor bleeding may stop without any treatment and cause no serious problems. More serious or large bleeds usually require surgery.

Image reprinted with permission from Medscape.com, 2011. Available at: medscape.com