Subdural & Epidural Hematomas
A hematoma is a collection of blood that forms outside of the normal blood vessels. In the brain, subdural hematomas and epidural hematomas are types of intracranial bleeding that occur in different locations around the brain.
A subdural hematoma occurs when blood collects between the brain’s outer covering (the dura) and the surface of the brain. It is often associated with a tear in small veins, commonly following a head injury.
An epidural hematoma occurs when blood collects between the skull and the dura. It is often associated with injury to an artery, frequently following a skull fracture.
The effects of these conditions can vary depending on the amount of bleeding, how quickly it develops, and the area of the brain affected.
Common Symptoms
Symptoms of subdural and epidural hematomas can vary depending on the size and location of the bleeding and how quickly it develops.
Possible symptoms may include:
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Headache
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Confusion or changes in alertness
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Drowsiness or fatigue
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Nausea or vomiting
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Dizziness or balance problems
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Weakness, numbness, or changes in sensation
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Difficulty speaking
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Vision changes
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Seizures
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Loss of consciousness
Some hematomas may develop symptoms immediately after an injury, while others may develop gradually over time.
Risk Factors and Causes
Subdural and epidural hematomas most commonly occur due to bleeding related to trauma, but certain factors may increase the likelihood of developing these conditions.
Potential causes and risk factors may include:
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Head injury: Falls, motor vehicle accidents, sports injuries, or other trauma can damage blood vessels around the brain.
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Age-related changes: Older adults may have increased risk of subdural hematomas due to changes in the brain and surrounding tissues.
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Blood-thinning medications: Certain medications that affect blood clotting may increase the risk of bleeding.
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Bleeding disorders: Conditions that affect the body ’s ability to form blood clots may contribute to bleeding risk.
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Alcohol-related factors: Long-term heavy alcohol use may be associated with an increased risk of subdural hematomas.
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Skull fractures: Epidural hematomas are often associated with skull fractures following head trauma.
How Subdural & Epidural Hematomas Can Be Treated
Treatment for subdural and epidural hematomas depends on factors such as the size and location of the bleeding, symptoms, rate of development, and overall health.
Treatment approaches may include:
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Observation and imaging follow-up: Some smaller hematomas may be monitored with repeat imaging and clinical evaluation.
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Medication management: Certain medications may be used to address symptoms or help manage contributing factors.
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Surgical procedures: When a hematoma causes significant pressure or neurological effects, procedures may be performed to remove collected blood and relieve pressure around the brain.
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Treatment of underlying factors: Addressing conditions that contribute to bleeding risk may be part of overall care.
A neurospecialist can evaluate imaging findings and the characteristics of a hematoma to discuss available treatment approaches based on each individual situation.