Epidural vs Subdural vs Subarachnoid vs Intracerebral Hematoma Facts Checked
“| Feature | Epidural Hematoma | Subdural Hematoma | Subarachnoid Hemorrhage | Intracerebral Hemorrhage | | -------------------------- | ------------------------------------------------------ | -------------------------------------------------------- | --------------------------------------------- | ------------------------------------------------- | | **Location** | Between skull and dura mater (epidural space) | Between dura mater and arachnoid mater | Between arachnoid and pia mater (CSF space) | Within brain tissue (parenchyma) | | **Anatomy involved** | Skull–dura separation | Dura–arachnoid separation | Blood mixes with cerebrospinal fluid | Brain tissue + deep vessels | | **Main mechanism** | Middle meningeal artery rupture | Bridging vein rupture | Rupture of berry (saccular) aneurysm | Rupture of small penetrating arteries | | **Common cause** | Temporal bone fracture (pterion = weak point) | Rapid acceleration–deceleration injury (whiplash, falls) | Hypertension, aneurysm rupture | Chronic hypertension, amyloid angiopathy | | **Bleeding type** | Arterial (rapid, high pressure) | Venous (slow, low pressure) | Arterial (sudden massive bleed) | Variable (deep vessel rupture) | | **Key symptom pattern** | Loss of consciousness → lucid interval → rapid decline | Gradual confusion, headache, no lucid interval | Sudden “worst headache of life” (thunderclap) | Focal neurological deficits (weakness, paralysis) | | **Lucid interval** | Present (classic exam clue) | Absent | Absent | Absent | | **CT appearance** | Lens-shaped (biconvex), limited spread | Crescent-shaped, spreads widely | Blood in sulci, cisterns, basal cisterns | Bleed inside brain tissue | | **Crosses sutures?** | No (blocked by dura attachment) | Yes | Yes | N/A | | **Crosses midline?** | No | No (falx cerebri blocks) | N/A | Can cause midline shift | | **Lumbar puncture** | Not used | Not used | Used if CT negative → xanthochromia | Contraindicated | | **Severe treatment** | Emergency burr hole / craniotomy | Surgical drainage if mass effect (>5 mm shift) | Endovascular coiling or surgical clipping | ICP control (mannitol) ± surgery | | **Life-threatening issue** | Rapid arterial brain compression | Slow venous pressure buildup | Vasospasm + rebleeding risk | Brain tissue destruction + swelling |”
Summary
The table’s description of epidural hematoma matches current medical references: it is an arterial bleed between the skull and dura mater, usually from a ruptured middle meningeal artery, appears as a lens‑shaped (biconvex) collection on CT that does not cross suture lines, often presents with a lucid interval, and requires emergency burr‑hole or craniotomy. The provided sources do not cover subdural, subarachnoid, or intracerebral hemorrhages, so their entries cannot be confirmed from this evidence.
Sources 58 searched
- Epidural Hematoma - StatPearls - NCBI Bookshelf - NIH
An epidural hematoma (EDH) is an extra-axial collection of blood within the potential space between the outer layer of the dura mater and the inner table of the skull. The hematoma is typically confined by the lateral sutures, particularly the coronal sutures, where the dura inserts.
- Epidural hematoma: MedlinePlus Medical Encyclopedia
An epidural hematoma (EDH) is bleeding between the inside of the skull and the outer covering of the brain (called the dura mater).
- Epidural Hematoma - an overview | ScienceDirect Topics
Epidural hematoma is defined as a collection of hemorrhage located between the dura mater and the inner table of the skull, typically presenting as a lenticular biconvex shape that does not cross suture lines.
- Traumatic Spinal Epidural Hematoma With Significant Neurologic Findings: A Case Report - PMC
Especially important to highlight is that our patient was not on anticoagulants, nor did she suffer from any coagulopathies, excluding a major risk factor of TSEH formation. The resulting hematoma was located in the cervicothoracic region, at the anterior aspect of the spinal canal, a feature rarely seen. Moreover, of significance to the clinical timeline is the specific vascular source of epidural bleeding.
- Clinical features of spontaneous spinal epidural hematoma - PMC
Case 7. (a) Computed tomography (CT) scan (sagittal view) showing a spindle-shaped mass lesion at the C4–C6 level (arrows). (b, c) Mixed intensity observed on T1- and T2-weighted magnetic resonance imaging (MRI) scans indicates a hematoma (arrows). (d, e) Axial CT and MRI scans showing an epidural hematoma at the left portion dorsal to the dural sac.
- Spontaneous cervical epidural hematoma of idiopathic etiology: Case report and review of literature - PMC
There is no evidence of any residual hematoma or cord displacement. On contrast study (C) there is no evidence of any pathological enhancement. Spinal epidural hematomas were first described by Jackson in 18691 and first treated surgically by Bain in 1897.2 The incidence of SSEH is estimated ...
- Epidural Hematoma - StatPearls - NCBI Bookshelf
Epidural hematoma (EDH) is an acute, life-threatening accumulation of blood between the dura mater and the inner table of the skull, most often resulting from blunt head trauma. The condition typically involves arterial bleeding, most commonly from a lacerated middle meningeal artery secondary ...
- Spontaneous spinal epidural hematoma management: a case series and literature review | Spinal Cord Series and Cases
Laboratory blood analyses revealed an INR of 2.5. An urgent MRI showed a four-leveled epidural hematoma extending from C4 to C7. An urgent laminectomy and evacuation of hematoma was performed, although time between ictus and surgery can be estimated ...
- Spinal epidural hematoma - PubMed
However, epidural hematoma in the lumbar spine is best described as the result of internal rupture of the Batson vertebral venous plexus. Clinical evaluation of pain control and neurologic deficit is the most important tool in early diagnosis. ...
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