Subdural vs Epidural Hematoma: A Comparison

In this blog post, we will compare two types of hematoma: the subdural and the epidural heamtomas. They both refer to interacranial bleeding and have distinct causes and occur at different locations. We will talk about each type separately and then compare them. So if you want to find out where is subdural hematoma located and how is that different to epidural hematoma then keep reading!
Frederika Malichová

Frederika Malichová

Neuroscientist at the University Of Cambridge.

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Subdural vs Epidural Hematoma

Subdural and epidural hematomas are both types of intracranial bleeding. However, they differ in the location and the cause. In brief, epidural hematoma occurs between the skull and the dura mater, often due to a skull fracture. A subdural hematoma, on the other hand, is found beneath the dura mater, typically caused by tearing of the veins due to a head injury.

Hematomas should not be confused with strokes or brain aneurysms.

What is a Epidural Hematoma?

Epidural hematoma is a characterized by the accumulation of blood between the skull and the protective covering of the brain [1].

The condition is often a result of trauma or head injury, causing the brain to bounce against the inside of the skull. This can lead to the damage of the brain’s internal lining, tissues and blood vessels, causing bleeding and the accumulation of blood between the space [1].

Interestingly, epidural hematomas can also occur in the spinal region. Such hematomas usually cause severe pain at the location of the hematoma and severe neurological deficits [2]. This suggests that the causes of epidural hematomas are multifactorial and can be observed on various parts of the body [3].

The formation of an epidural hematoma can cause further complications. In the brain, the hematoma can put pressure on the brain, causing it to swell, which can lead to a potential shift within the skull. Such pressure can then further contribute to alterations in vision, speech, mobility or consciousness.

It is crucial to treat epidural hematoma, because it may lead to long-lasting brain damage or even death [1].

Unfortunately, symptoms of subdural hematoma may not appear for several weeks and often times it may lead to difficulties with dealing with the condition as the treatment is given to the individual later [4].

What Is a Subdural Hematoma?

A subdural hematoma is a type of bleeding that occurs in between the inner layer of the dura mater and the arachnoid mater (both of which are protective layers of the brain). Subdural hematomas can either be chronic or acute.

A subdural hematoma is caused when a vein tears between the skull and the brain’s surface, creating a blood clot on the brain’s surface [4].

We usually observe subdural hematomas after a head injury [4]. However, subdural hematomas can also occur without a history of brain trauma [5].

The symptoms of a subdural hematoma vary, but the individual with subdural hematoma may experience severe headaches and oculomotor disorders (problems with eye movement). Unfortunately, symptoms of subdural hematoma may not appear for several weeks and often times it may lead to difficulties with dealing with the condition as the treatment is given to the individual later [4].

How Can We Treat Epidural and Subdural Hepatoma?

Summary: Epidural vs Subdural Hepatoma

Epidural and subdural hematomas are both types of bleeding that occur outside the brain but within the skull. However, they differ in their location and the vessels involved.

Firstly, epidural hematomas occur between the dura mater and the skull, while subdural hematomas are found in between the dura mater and the arachnoid mater. Secondly, epidural hematomas are caused by a rupture of the middle meningeal artery leading to a fast accumulation of blood under high pressure.

Subdural hematomas, on the other hand, are usually caused by the tearing of bridging veins and leads to a slower accumulation of blood under lower pressure.

Because of the difference in the cause of these two hematomas, there is a difference between their appearance: epidural hematomas are usually in a form of well-localized biconvex-shaped mass while the subdural hematomas are more widespread, crescent-shaped collection of blood [6, 7].

However, for instance in liver cancer, both types of hematomas may occur due to metastasis to the dura mater or the skull. In fact there was a patient case report, where the patient developed both chronic subdural and an acute epidural hematoma due to metastasis on the dura mater [8, 9].

In conclusion, while there are similarities in these two types of hematomas, there are also differences which can distinguish these two apart. But it is important to remember that both are serious conditions.

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Frederika Malichová

Frederika Malichová

Frederika is a postgraduate researcher at the University of Cambridge, where she investigates new biomarkers for Frontotemporal Dementia and other tauopathies. Her research has been published at prestigious conferences such as the Alzheimer’s Association International Conference 2023. She obtained her BSc in Biomedical Sciences from UCL, where she worked closely with the UK Dementia Research Institute.