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A subdural hematoma (SDH) is a form of traumatic brain injury in which blood collects between the dura (the outer protective covering of the brain) and the arachnoid (the middle layer of the meninges). Unlike in epidural hematomas, which are usually caused by tears in arteries, subdural bleeding usually results from tears in veins that cross the subdural space. This bleeding often separates the dura and the arachnoid layers. Subdural hemorrhages may cause an increase in intracranial pressure (ICP), which can cause compression of and damage to delicate brain tissue. Acute subdural hematoma (ASDH) has a high mortality rate and is a severe medical emergency. Image File history File links Metadata Size of this preview: 491 × 599 pixelsFull resolution (1159 × 1415 pixel, file size: 238 KB, MIME type: image/jpeg) This CT scan is an example of Subdural haemorrhage caused by trauma. ...
The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ...
The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ...
// S00-T14 - Injury (S00-S09) head (S00) Superficial injury of head (S01) Open wound of head (S02) Fracture of skull and facial bones (S03) Dislocation, sprain and strain of joints and ligaments of head (S04) Injury of cranial nerves (S05) Injury of eye and orbit (S06) Intracranial injury (S07) Crushing...
The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ...
The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ...
The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ...
MedlinePlus (medlineplus. ...
eMedicine is an online clinical medical knowledge base that was founded in 1996. ...
Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ...
Hematoma on an elbow, nine days after a blood sample was taken Hematoma on a forearm, one day after repeated shocks A hematoma, or haematoma, is a collection of blood, generally the result of hemorrhage, or, more specifically, internal bleeding. ...
Traumatic brain injury (TBI), traumatic injuries to the brain, also called intracranial injury, or simply head injury, occurs when a sudden trauma causes brain damage. ...
Human blood smear: a - erythrocytes; b - neutrophil; c - eosinophil; d - lymphocyte. ...
The dura mater (from the Latin hard mother), or pachymeninx, is the tough and inflexible outermost of the three layers of the meninges surrounding the brain. ...
Italic text // ahh addiing sum spiice iin hurr`` For other uses, see Brain (disambiguation). ...
The arachnoid layer is the second or middle layer of the meninges, the membranes surrounding the brain. ...
The meninges (singular meninx) are the system of membranes that envelop the central nervous system. ...
Epidural or extradural hematoma is a buildup of blood occurring between the dura mater (the brains tough outer membrane) and the skull. ...
Section of an artery For other uses, see Artery (disambiguation). ...
The subdural space (or subdural cavity) is an artificial space created by the separation of the arachnoid mater from the dura mater as the result of trauma or pathologic process. ...
Intracranial pressure, (ICP), is the pressure exerted by the cranium on the brain tissue, cerebrospinal fluid (CSF), and the brains circulating blood volume. ...
A medical emergency is an injury or illness that poses an immediate threat to a persons health or life which requires help from a doctor or hospital. ...
Causes
Subdural hematomas are most often caused by head injury, when rapidly changing velocities within the skull may stretch and tear small bridging veins. Subdural hematomas due to head injury are described as traumatic. Much more common than epidural hemorrhages, subdural hemorrhages generally result from shearing injuries due to various rotational or linear forces (University of Vermont; Wagner, 2004). It is also commonly seen in the elderly and in alcoholics, who have evidence of brain atrophy. Cerebral atrophy increases the length the bridging veins have to traverse between the two meningeal layers, hence increasing the likelihood of shearing forces causing a tear. It is also more common in patients on anticoagulants, esp Aspirin and Warfarin. Patients on these medications can have a subdural hematoma with a minor injury. Head injury is a trauma to the head, that may or may not include injury to the brain (see also brain injury). ...
In physics, velocity is defined as the rate of change of displacement or the rate of displacement. ...
It has been suggested that temporal fenestra be merged into this article or section. ...
In the circulatory system, a vein is a blood vessel that carries blood toward the heart. ...
In medicine, a trauma patient has suffered serious and life-threatening physical injury resulting in secondary complications such as shock, respiratory failure and death. ...
Epidural or extradural hematoma is a buildup of blood occurring between the dura mater (the brains tough outer membrane) and the skull. ...
Signs and symptoms Symptoms of subdural hemorrhage have a slower onset than those of epidural hemorrhages because the lower pressure veins bleed more slowly than arteries. Thus, signs and symptoms may show up within 24 hours but can be delayed as much as 2 weeks (Sanders and McKenna, 2001). If the bleeds are large enough to put pressure on the brain, signs of increased ICP or damage to part of the brain will be present (Wagner, 2004). Epidural or extradural hematoma is a buildup of blood occurring between the dura mater (the brains tough outer membrane) and the skull. ...
Intracranial pressure, (ICP), is the pressure exerted by the cranium on the brain tissue, cerebrospinal fluid (CSF), and the brains circulating blood volume. ...
Other signs and symptoms of subdural hematoma include the following: Look up signs in Wiktionary, the free dictionary. ...
The term symptom (from the Greek meaning chance, mishap or casualty, itself derived from συμπιπτω meaning to fall upon or to happen to) has two similar meanings in the context of physical and mental health: Strictly, a symptom is a sensation or change in health function experienced by a patient. ...
Head injury is a trauma to the head, that may or may not include injury to the brain (see also brain injury). ...
Consciousness is a quality of the mind generally regarded to comprise qualities such as subjectivity, self-awareness, sentience, sapience, and the ability to perceive the relationship between oneself and ones environment. ...
This article is about the medical condition. ...
Paresthesia (paraesthesia in British) is a sensation of tingling, pricking, or numbness of the skin with no apparent physical cause, more generally known as the feeling of pins and needles. ...
A headache (cephalalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ...
// Pre-syncope is a sensation of feeling faint. ...
Orientation is a function of the mind involving awareness of three dimensions: (1) time, (2) place and (3) person. ...
Amnesia or amnæsia (from Greek ) (see spelling differences) is a condition in which memory is disturbed. ...
Fatigue is a feeling of excessive tiredness or lethargy, with a desire to rest, perhaps to sleep. ...
For the Beck song, see Nausea (song). ...
Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ...
Dysphasia is a speech disorder in which there is an impairment of speech and of comprehension of speech. ...
Look up dysarthria in Wiktionary, the free dictionary. ...
For other uses, see Ataxia (disambiguation). ...
The tone or style of this article or section may not be appropriate for Wikipedia. ...
Features Most of the time, subdural hematomas occur around the tops and sides of the frontal and parietal lobes (University of Vermont; Wagner, 2004). They also occur in the posterior fossa, and near the falx cerebri and tentorium (Wagner, 2004). Unlike epidural hematomas, which cannot expand past the sutures of the skull, subdural hematomas can expand along the inside of the skull, creating a convex shape that follows the curve of the brain, stopping only at the dural reflections like the tentorium and falx cerebri. The frontal lobe is an area in the brain of vertebrates. ...
The parietal lobe is a lobe in the brain. ...
Fossa has several meanings. ...
The falx cerebri (Latin: scythe of the brain) is an extension of the protective dura mater that projects into the longitudinal fissure that seperates the two cerebral hemispheres. ...
The tentorium cerebelli (Latin: tent of the cerebellum) is an extension of the dura mater that seperates the cerebellum from the inferior portion of the occipital lobes. ...
Nontraumatic epidural hematoma in a young woman. ...
Side view of the skull. ...
On a CT scan, subdural hematomas are crescent-shaped, with a concave surface away from the skull. Subdural blood can also be seen as a layering density along the tentorium cerebelli. This can be a chronic, stable process, since the feeding system is low-pressure. In such cases, subtle signs of bleeding such as effacement of sulci or medial displacement of the junction between gray matter and white matter may be apparent. A chronic bleed can be the same density as brain tissue (called isodense to brain), meaning that it will show up on CT scan as the same shade as brain tissue, potentially obscuring the finding. CAT apparatus in a hospital Computed axial tomography (CAT), computer-assisted tomography, computed tomography, CT, or body section roentgenography is the process of using digital processing to generate a three-dimensional image of the internals of an object from a large series of two-dimensional X-ray images taken around...
The tentorium cerebelli (Latin: tent of the cerebellum) is an extension of the dura mater that seperates the cerebellum from the inferior portion of the occipital lobes. ...
A sulcus (pl. ...
Grey matter (or gray matter) is a major component of the central nervous system, consisting of nerve cell bodies, glial cells (astroglia and oligodendrocytes), capillaries, and short nerve cell extensions/processes (axons and dendrites). ...
White matter is one of the two main solid components of the central nervous system. ...
Subtypes Subdural hematomas are divided into acute, subacute, and chronic, depending on their speed of onset. Acute subdural hematomas that are due to trauma are the most lethal of all head injuries and have a high mortality rate if they are not rapidly treated with surgical decompression. In medicine, an acute disease is a disease with either or both of: a rapid onset; a short course (as opposed to a chronic course). ...
In medicine, a chronic disease is a disease that is long-lasting or recurrent. ...
Crude death rate by country Mortality rate is a measure of the number of deaths (in general, or due to a specific cause) in some population, scaled to the size of that population, per unit time. ...
Acute bleeds develop after high speed acceleration or deceleration injuries and are increasingly severe with larger hematomas. They are most severe if associated with cerebral contusions (Wagner, 2004). Though much faster than chronic subdural bleeds, acute subdural bleeding is usually venous and therefore slower than the usually arterial bleeding of an epidural hemorrhage. Acute subdural bleeds have a high mortality rate, higher even than epidural hematomas and diffuse brain injuries, because the velocities necessary to cause them cause other severe injuries as well (Vinas and Pilistis, 2004; National Guideline Clearinghouse, 2005). The mortality rate associated with acute subdural hematoma is around 60 to 80% (Dawodu, 2004). Brain contusion, a form of traumatic brain injury, is a bruise of the brain tissue. ...
Epidural or extradural hematoma is a buildup of blood occurring between the dura mater (the brains tough outer membrane) and the skull. ...
Chronic subdural bleeds develop over the period of days to weeks, often after minor head trauma, though such a cause is not identifiable in 50% of patients (Downie, 2001). The bleeding from a chronic bleed is slow, probably from repeated minor bleeds, and usually stops by itself (University of Vermont; Graham and Gennareli, 2000). Since these bleeds progress slowly, they present the chance to be stopped before they cause significant damage. Small subdural hematomas, those less than a centimeter wide, have much better outcomes than acute subdural bleeds: in one study, only 22% of patients with chronic subdural bleeds had outcomes worse than "good" or "complete recovery" (Wagner, 2004).
Pathophysiology Collected blood from the subdural bleed may draw in water due to osmosis, causing it to expand, which may compress brain tissue and cause new bleeds by tearing other blood vessels (Downie, 2001). The collected blood may even develop its own membrane (McCaffrey, 2001). Osmosis is the net movement of water across a partially permeable membrane from a region of high solvent potential to an area of low solvent potential, up a solute concentration gradient. ...
In some subdural bleeds, the arachnoid layer of the meninges is torn, and cerebrospinal fluid (CSF) and blood both expand in the intracranial space, increasing pressure (University of Vermont). The Arachnoid mater is one of the three layers of the meninges, interposed between the dura mater and the pia mater and separated from the pia mater by the subarachnoid space. ...
The meninges (singular meninx) are the system of membranes that envelop the central nervous system. ...
Cerebrospinal fluid (CSF), Liquor cerebrospinalis, is a clear bodily fluid that occupies the subarachnoid space in the brain (the space between the skull and the cerebral cortex—more specifically, between the arachnoid and pia layers of the meninges). ...
The cranial cavity is the relatively large space formed inside the skull. ...
Substances that cause vasoconstriction may be released from the collected material in a subdural hematoma, causing further ischemia under the site by restricting blood flow to the brain (Graham and Gennareli, 2000). When the brain is denied adequate blood flow, a biochemical cascade known as the ischemic cascade is unleashed, and may ultimately lead to brain cell death. In medicine, ischemia (Greek ισχαιμία, isch- is restriction, hema or haema is blood) is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. ...
A Biochemical Cascade is a series of chemical reactions in which the products of one reaction are consumed in the next reaction. ...
The ischemic cascade is a series of biochemical reactions that take place in the brain after seconds to minutes of ischemia (inadequate blood supply) (Arnold, 2003). ...
Drawing of the structure of cork as it appeared under the microscope to Robert Hooke from Micrographia which is the origin of the word cell. Cells in culture, stained for keratin (red) and DNA (green). ...
The body gradually reabsorbs the clot and replaces it with granulation tissue. Medicine is a branch of health science concerned with maintaining human health and restoring it by treating disease and injury; it is both an area of knowledge, a science of body systems and diseases and their treatment, and the applied practice of that knowledge. ...
Treatment It is important that a patient receive medical assessment, including a complete neurological examination, after any head trauma. A CT scan or MRI scan will usually detect significant subdural hematomas. Neurology is a branch of medicine dealing with disorders of the nervous system. ...
CAT apparatus in a hospital Computed axial tomography (CAT), computer-assisted tomography, computed tomography, CT, or body section roentgenography is the process of using digital processing to generate a three-dimensional image of the internals of an object from a large series of two-dimensional X-ray images taken around...
MRI Image Magnetic resonance imaging (MRI) is a method of creating images of the inside of opaque organs in living organisms as well as detecting the amount of bound water in geological structures. ...
Treatment of a subdural hematoma depends on its size and rate of growth. Small subdural hematomas can be managed by careful monitoring until the body heals itself. Large or symptomatic hematomas require a craniotomy, the surgical opening of the skull. A surgeon then opens the dura, removes the blood clot with suction or irrigation, and identifies and controls sites of bleeding. Postoperative complications include increased intracranial pressure, brain edema, new or recurrent bleeding, infection, and seizure. A craniotomy is a surgical operation in which part of the skull (part of the cranium) is removed in order to access the brain. ...
It has been suggested that temporal fenestra be merged into this article or section. ...
Dura may refer to: Dura (linguistics), a critically endangered language of Nepal Dura mater, the outer membrane of the meninges which envelop the brain and spinal cord This is a disambiguation page, a list of pages that otherwise might share the same title. ...
A thrombus is the final product of blood coagulation, through the aggregation of platelets and the activation of the humoral coagulation system. ...
Blood from a finger Bleeding is the loss of blood from the body. ...
Intracranial pressure, (ICP), is the pressure exerted by the cranium on the brain tissue, cerebrospinal fluid (CSF), and the brains circulating blood volume. ...
This page is about the condition called oedema. ...
Blood from a finger Bleeding is the loss of blood from the body. ...
An infection is the detrimental colonization of a host organism by a foreign species. ...
This article is about the medical term, epileptic seizure, as distinct from a non-epileptic seizure. ...
Risk factors Factors increasing the risk of a subdural hematoma include very young or very old age. As the brain shrinks with age, the subdural space enlarges and the veins that traverse the space must travel over a wider distance, making them more vulnerable to tears. This and the fact that the elderly have more brittle veins make chronic subdural bleeds more common in older patients (Downie, 2001). Infants, too, have larger subdural spaces and are more predisposed to subdural bleeds than are young adults (Wagner, 2004). For this reason, subdural hematoma is a common finding in shaken baby syndrome. In juveniles, an arachnoid cyst is a risk factor for a subdural hematoma (Mori 2002). It has been suggested that Longevity genes be merged into this article or section. ...
The subdural space (or subdural cavity) is an artificial space created by the separation of the arachnoid mater from the dura mater as the result of trauma or pathologic process. ...
In the circulatory system, a vein is a blood vessel that carries blood toward the heart. ...
Shaken baby syndrome (SBS) is a form of child abuse affecting between 1,200 and 1,600 children every year in the USA.[1] SBS encompasses a variety of outcomes that are attributed to shaking an infant or small child. ...
Arachnoid cysts are cerebrospinal fluid covered by arachnoidal cells and collagen[1] that may develop between the surface of the brain and the cranial base or on the arachnoid membrane, one of the three membranes that cover the brain and the spinal cord. ...
Other risk factors for subdural bleeds include taking blood thinners (anticoagulants), long-term alcohol abuse, and dementia. An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. ...
Alcoholism is the consumption of, or preoccupation with, alcoholic beverages to the extent that this behavior interferes with the drinkers normal personal, family, social, or work life, and may lead to physical or mental harm. ...
For other uses, see Dementia (disambiguation). ...
See also Head injury is a trauma to the head, that may or may not include injury to the brain (see also brain injury). ...
Traumatic brain injury (TBI), traumatic injuries to the brain, also called intracranial injury, or simply head injury, occurs when a sudden trauma causes brain damage. ...
Intra-axial hemorrhages, or intra-axial hematomas, are a subtype of intracranial hemorrhage that occur within the brain tissue itself. ...
Extra-axial hematoma, or extra-axial hemorrhage is a subtype of intracranial hemorrhage, or bleeding within the intracranial space, that occurs within the skull but outside of the brain tissue itself. ...
Nontraumatic epidural hematoma in a young woman. ...
A subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space surrounding the brain, i. ...
Concussion, or mild traumatic brain injury (MTBI), is the most common and least serious type of traumatic brain injury. ...
Diffuse axonal injury (DAI) is one of the most common and devastating types of brain injury (Iwata , 2004), occurring in almost half of all cases of severe head trauma (Park and Hyun, 2004). ...
References - Dawodu S. 2004. "Traumatic brain injury: Definition, epidemiology, pathophysiology" Emedicine.com.
- Downie A. 2001. "Tutorial: CT in head trauma"
- Graham DI and Gennareli TA. Chapter 5, "Pathology of brain damage after head injury" Cooper P and Golfinos G. 2000. Head Injury, 4th Ed. Morgan Hill, New York.
- McCaffrey P. 2001. "The neuroscience on the web series: CMSD 336 neuropathologies of language and cognition." California State University, Chico.
- National Guideline Clearinghouse. 2005. Firstgov.
- Sanders MJ and McKenna K. 2001. Mosby’s Paramedic Textbook, 2nd revised Ed. Chapter 22, "Head and facial trauma." Mosby.
- Surinder KN and Raman K. 2005. Extracranial redistribution causing rapid spontaneous resolution of acute subdural hematoma. Neuroimage, 53(1): 124
- University of Vermont College of Medicine. "Neuropathology: Trauma to the CNS."
- Wagner AL. 2004. "Subdural hematoma." Emedicine.com.
- Mori K, Yamamoto T, Horinaka N, Maeda M. "Arachnoid cyst is a risk factor for chronic subdural hematoma in juveniles: twelve cases of chronic subdural hematoma associated with arachnoid cyst." J Neurotrauma, 2002 Sep;19(9):1017-27. (PMID 12482115)
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