{"id":5502,"date":"2025-12-09T19:12:07","date_gmt":"2025-12-10T00:12:07","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&#038;p=5502"},"modified":"2025-12-09T23:17:21","modified_gmt":"2025-12-10T04:17:21","slug":"intracranial-hematomas","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/intracranial-hematomas\/","title":{"raw":"11p18  Intracranial Hematomas:  Types and Locations","rendered":"11p18  Intracranial Hematomas:  Types and Locations"},"content":{"raw":"<h1><strong>Intracranial Hematoma Definition:<\/strong><\/h1>\r\n<ul>\r\n \t<li>a <strong>collection of blood<\/strong> inside the skull, usually from a <strong>burst blood vessel<\/strong> or <strong>head injury<\/strong>, that can be dangerous as the hematoma presses on the brain and also induces <strong>inflammation<\/strong> which can further increase intracranial pressure (ICP).<\/li>\r\n<\/ul>\r\n<h1><strong>1.\u00a0 Epidural Hematoma<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Location<\/strong>: Between\u00a0<strong>skull<\/strong>\u00a0and\u00a0<strong>dura mater<\/strong>\u00a0(extra dural space,\u00a0<strong>epidural<\/strong>).<\/li>\r\n \t<li>Often caused by arterial bleed, more accessible surgically.<\/li>\r\n \t<li><strong>Symptoms<\/strong>: Loss of consciousness, then a\u00a0<strong>lucid interval<\/strong>, followed by rapid deterioration.<\/li>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li>Requires\u00a0<strong>monitoring<\/strong>\u00a0and possibly\u00a0<strong>surgical removal<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>2.\u00a0 Subdural Hematoma<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Location<\/strong>: Between\u00a0<strong>dura mater<\/strong>\u00a0and\u00a0<strong>arachnoid mater<\/strong>\u00a0(<strong>subdural space<\/strong>).<\/li>\r\n \t<li>Usually venous bleed, slower onset.<\/li>\r\n \t<li>Symptoms:\u00a0<strong>Headache<\/strong>, confusion, progressing to coma.<\/li>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li>Requires\u00a0<strong>monitoring<\/strong>\u00a0and possibly\u00a0<strong>surgical removal<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>3.\u00a0 Subarachnoid Hemorrhage<\/strong><\/h1>\r\n<ul>\r\n \t<li>Bleeding into the <strong>subarachnoid space<\/strong> between <strong>arachnoid<\/strong>\u00a0and\u00a0<strong>pia mater<\/strong>.\r\n<ul>\r\n \t<li>Drains\u00a0<strong>via arachnoid villi<\/strong>\u00a0into venous system.<\/li>\r\n \t<li>Usually\u00a0<strong>does not<\/strong>\u00a0increase ICP significantly.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Blood mixes with\u00a0<strong>CSF<\/strong> in the <strong>subarachnoid space<\/strong>, and can drain through <strong>dura (venous) sinuses<\/strong> into jugular vein, leading to less chance of increased ICP, in comparison with with intracranial hematomas - unless dura sinus(es) are obstructed.<\/li>\r\n \t<li>Symptoms:\u00a0<strong>Sudden headache<\/strong>,\u00a0<strong>neck stiffness<\/strong>,\u00a0<strong>nausea<\/strong>.<\/li>\r\n<\/ul>\r\n<h1><strong>4.\u00a0 Intracerebral Hematoma<\/strong><\/h1>\r\n<ul>\r\n \t<li>Bleeding\u00a0<strong>within brain tissue<\/strong>\u00a0itself.<\/li>\r\n \t<li>Often occurs after shearing injury or rupture of vessels.<\/li>\r\n \t<li>Develops\u00a0<strong>over days<\/strong>; symptomatic from mass effect and bleeding.<\/li>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li>Requires\u00a0<strong>monitoring<\/strong>\u00a0and possibly\u00a0<strong>surgical removal<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Pathophysiology and Effects of Hematomas<\/strong><\/h1>\r\n<ul>\r\n \t<li>Hematomas\u00a0<strong>increase volume<\/strong>\u00a0within the skull.<\/li>\r\n \t<li><strong>Expanding mass<\/strong>\u00a0causes\u00a0<strong>pressure<\/strong>:\r\n<ul>\r\n \t<li>Compresses surrounding tissue.<\/li>\r\n \t<li>Elevated\u00a0<strong>intracranial pressure (ICP)<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Collapse of vessels<\/strong>\u00a0causes\u00a0<strong>ischemia<\/strong>.<\/li>\r\n \t<li><strong>Blood cell rupture<\/strong>\u00a0releases\u00a0<strong>hemoglobin<\/strong>\u00a0and\u00a0<strong>electrolytes<\/strong>:\r\n<ul>\r\n \t<li>Draws water into the space (<strong>edema<\/strong>).<\/li>\r\n \t<li>May worsen ICP further.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Neuronal death<\/strong>\u00a0occurs if ICP is not relieved.<\/li>\r\n<\/ul>\r\n<h1><strong>Intra-cranial Pressure &amp; Compensation<\/strong><\/h1>\r\n<ul>\r\n \t<li>CSF\u00a0<strong>circulates<\/strong>\u00a0in ventricles, produced in the\u00a0<strong>choroid plexus<\/strong>.<\/li>\r\n \t<li>Increased ICP causes\u00a0<strong>ventricles<\/strong>\u00a0to\u00a0<strong>shrink<\/strong>\u00a0as CSF is pushed out.<\/li>\r\n \t<li>Excess blood or swelling can\u00a0<strong>push on brain tissue<\/strong>.<\/li>\r\n<\/ul>\r\n<h1><strong>Intracranial Hematomas:\u00a0 Critical Considerations<\/strong><\/h1>\r\n<ul>\r\n \t<li>Continuous\u00a0<strong>imaging<\/strong>\u00a0(CT, MRI) essential for monitoring.<\/li>\r\n \t<li>Rapid\u00a0<strong>decompression<\/strong>\u00a0or <strong>hematoma evacuation<\/strong> to prevent\u00a0<strong>brain herniation<\/strong>.\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li><strong>Craniectomy<\/strong>:\r\n<ul>\r\n \t<li>Removal of part of the skull to\u00a0<strong>relieve pressure<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Hematoma evacuation:<\/strong>\r\n<ul>\r\n \t<li>Remove <strong>subdural<\/strong>\u00a0or\u00a0<strong>epidural<\/strong>\u00a0hematomas.<\/li>\r\n \t<li>Typically performed if the hematoma is large or causing significant pressure.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Careful management to\u00a0<strong>reduce ICP<\/strong>, prevent\u00a0<strong>brain ischemia<\/strong>.<\/li>\r\n \t<li><strong>Supportive Care<\/strong>\r\n<ul>\r\n \t<li><strong>Blood transfusions<\/strong>\u00a0if hemorrhage is severe.<\/li>\r\n \t<li><strong>Monitoring ICP<\/strong>:\r\n<ul>\r\n \t<li>Use\u00a0<strong>catheters<\/strong>\u00a0and\u00a0<strong>pressure monitors<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Prevent secondary damage<\/strong>:\r\n<ul>\r\n \t<li>Maintain\u00a0<strong>blood pressure<\/strong>,\u00a0<strong>oxygenation<\/strong>, and\u00a0<strong>nutritional support<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h2><strong>Summary<\/strong><\/h2>\r\n<ul>\r\n \t<li><strong>Skull fractures<\/strong> and <strong>intracranial hematomas<\/strong> can cause\u00a0<strong>life-threatening pressure<\/strong>.<\/li>\r\n \t<li>Imaging is essential for accurate diagnosis and management.<\/li>\r\n \t<li>Pharmacologic and surgical treatments aim to\u00a0<strong>reduce ICP<\/strong>,\u00a0<strong>prevent neuronal death<\/strong>, and\u00a0<strong>treat underlying blood\/fluid collections<\/strong>.<\/li>\r\n \t<li>Hematoma types depend on location (epidural, subdural, subarachnoid, intracerebral).<\/li>\r\n \t<li><strong>Early detection<\/strong>\u00a0and\u00a0<strong>treatment<\/strong>\u00a0are vital to prevent\u00a0<strong>brain herniation<\/strong>\u00a0and\u00a0<strong>death<\/strong>.<\/li>\r\n<\/ul>","rendered":"<h1><strong>Intracranial Hematoma Definition:<\/strong><\/h1>\n<ul>\n<li>a <strong>collection of blood<\/strong> inside the skull, usually from a <strong>burst blood vessel<\/strong> or <strong>head injury<\/strong>, that can be dangerous as the hematoma presses on the brain and also induces <strong>inflammation<\/strong> which can further increase intracranial pressure (ICP).<\/li>\n<\/ul>\n<h1><strong>1.\u00a0 Epidural Hematoma<\/strong><\/h1>\n<ul>\n<li><strong>Location<\/strong>: Between\u00a0<strong>skull<\/strong>\u00a0and\u00a0<strong>dura mater<\/strong>\u00a0(extra dural space,\u00a0<strong>epidural<\/strong>).<\/li>\n<li>Often caused by arterial bleed, more accessible surgically.<\/li>\n<li><strong>Symptoms<\/strong>: Loss of consciousness, then a\u00a0<strong>lucid interval<\/strong>, followed by rapid deterioration.<\/li>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Requires\u00a0<strong>monitoring<\/strong>\u00a0and possibly\u00a0<strong>surgical removal<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>2.\u00a0 Subdural Hematoma<\/strong><\/h1>\n<ul>\n<li><strong>Location<\/strong>: Between\u00a0<strong>dura mater<\/strong>\u00a0and\u00a0<strong>arachnoid mater<\/strong>\u00a0(<strong>subdural space<\/strong>).<\/li>\n<li>Usually venous bleed, slower onset.<\/li>\n<li>Symptoms:\u00a0<strong>Headache<\/strong>, confusion, progressing to coma.<\/li>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Requires\u00a0<strong>monitoring<\/strong>\u00a0and possibly\u00a0<strong>surgical removal<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>3.\u00a0 Subarachnoid Hemorrhage<\/strong><\/h1>\n<ul>\n<li>Bleeding into the <strong>subarachnoid space<\/strong> between <strong>arachnoid<\/strong>\u00a0and\u00a0<strong>pia mater<\/strong>.\n<ul>\n<li>Drains\u00a0<strong>via arachnoid villi<\/strong>\u00a0into venous system.<\/li>\n<li>Usually\u00a0<strong>does not<\/strong>\u00a0increase ICP significantly.<\/li>\n<\/ul>\n<\/li>\n<li>Blood mixes with\u00a0<strong>CSF<\/strong> in the <strong>subarachnoid space<\/strong>, and can drain through <strong>dura (venous) sinuses<\/strong> into jugular vein, leading to less chance of increased ICP, in comparison with with intracranial hematomas &#8211; unless dura sinus(es) are obstructed.<\/li>\n<li>Symptoms:\u00a0<strong>Sudden headache<\/strong>,\u00a0<strong>neck stiffness<\/strong>,\u00a0<strong>nausea<\/strong>.<\/li>\n<\/ul>\n<h1><strong>4.\u00a0 Intracerebral Hematoma<\/strong><\/h1>\n<ul>\n<li>Bleeding\u00a0<strong>within brain tissue<\/strong>\u00a0itself.<\/li>\n<li>Often occurs after shearing injury or rupture of vessels.<\/li>\n<li>Develops\u00a0<strong>over days<\/strong>; symptomatic from mass effect and bleeding.<\/li>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Requires\u00a0<strong>monitoring<\/strong>\u00a0and possibly\u00a0<strong>surgical removal<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Pathophysiology and Effects of Hematomas<\/strong><\/h1>\n<ul>\n<li>Hematomas\u00a0<strong>increase volume<\/strong>\u00a0within the skull.<\/li>\n<li><strong>Expanding mass<\/strong>\u00a0causes\u00a0<strong>pressure<\/strong>:\n<ul>\n<li>Compresses surrounding tissue.<\/li>\n<li>Elevated\u00a0<strong>intracranial pressure (ICP)<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Collapse of vessels<\/strong>\u00a0causes\u00a0<strong>ischemia<\/strong>.<\/li>\n<li><strong>Blood cell rupture<\/strong>\u00a0releases\u00a0<strong>hemoglobin<\/strong>\u00a0and\u00a0<strong>electrolytes<\/strong>:\n<ul>\n<li>Draws water into the space (<strong>edema<\/strong>).<\/li>\n<li>May worsen ICP further.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Neuronal death<\/strong>\u00a0occurs if ICP is not relieved.<\/li>\n<\/ul>\n<h1><strong>Intra-cranial Pressure &amp; Compensation<\/strong><\/h1>\n<ul>\n<li>CSF\u00a0<strong>circulates<\/strong>\u00a0in ventricles, produced in the\u00a0<strong>choroid plexus<\/strong>.<\/li>\n<li>Increased ICP causes\u00a0<strong>ventricles<\/strong>\u00a0to\u00a0<strong>shrink<\/strong>\u00a0as CSF is pushed out.<\/li>\n<li>Excess blood or swelling can\u00a0<strong>push on brain tissue<\/strong>.<\/li>\n<\/ul>\n<h1><strong>Intracranial Hematomas:\u00a0 Critical Considerations<\/strong><\/h1>\n<ul>\n<li>Continuous\u00a0<strong>imaging<\/strong>\u00a0(CT, MRI) essential for monitoring.<\/li>\n<li>Rapid\u00a0<strong>decompression<\/strong>\u00a0or <strong>hematoma evacuation<\/strong> to prevent\u00a0<strong>brain herniation<\/strong>.\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li><strong>Craniectomy<\/strong>:\n<ul>\n<li>Removal of part of the skull to\u00a0<strong>relieve pressure<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Hematoma evacuation:<\/strong>\n<ul>\n<li>Remove <strong>subdural<\/strong>\u00a0or\u00a0<strong>epidural<\/strong>\u00a0hematomas.<\/li>\n<li>Typically performed if the hematoma is large or causing significant pressure.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Careful management to\u00a0<strong>reduce ICP<\/strong>, prevent\u00a0<strong>brain ischemia<\/strong>.<\/li>\n<li><strong>Supportive Care<\/strong>\n<ul>\n<li><strong>Blood transfusions<\/strong>\u00a0if hemorrhage is severe.<\/li>\n<li><strong>Monitoring ICP<\/strong>:\n<ul>\n<li>Use\u00a0<strong>catheters<\/strong>\u00a0and\u00a0<strong>pressure monitors<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Prevent secondary damage<\/strong>:\n<ul>\n<li>Maintain\u00a0<strong>blood pressure<\/strong>,\u00a0<strong>oxygenation<\/strong>, and\u00a0<strong>nutritional support<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><strong>Summary<\/strong><\/h2>\n<ul>\n<li><strong>Skull fractures<\/strong> and <strong>intracranial hematomas<\/strong> can cause\u00a0<strong>life-threatening pressure<\/strong>.<\/li>\n<li>Imaging is essential for accurate diagnosis and management.<\/li>\n<li>Pharmacologic and surgical treatments aim to\u00a0<strong>reduce ICP<\/strong>,\u00a0<strong>prevent neuronal death<\/strong>, and\u00a0<strong>treat underlying blood\/fluid collections<\/strong>.<\/li>\n<li>Hematoma types depend on location (epidural, subdural, subarachnoid, intracerebral).<\/li>\n<li><strong>Early detection<\/strong>\u00a0and\u00a0<strong>treatment<\/strong>\u00a0are vital to prevent\u00a0<strong>brain herniation<\/strong>\u00a0and\u00a0<strong>death<\/strong>.<\/li>\n<\/ul>\n","protected":false},"author":1370,"menu_order":24,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[60],"license":[57],"class_list":["post-5502","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon","license-cc-by-nc-sa"],"part":76,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5502","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":6,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5502\/revisions"}],"predecessor-version":[{"id":5510,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5502\/revisions\/5510"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/76"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5502\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=5502"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=5502"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=5502"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=5502"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}