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Subdural vs. Epidural Hematoma

May 3, 2023 11:10:18 AM

Studies show that suffering a head injury can double one's risk of premature death. Head injuries, even if they don't seem serious right away, are incredibly dangerous.

Some head injuries result in intracranial hematomas. Subdural and epidural hematomas can be life-threatening, and even when they're not, they can cause serious long-term harm.

After a head injury, it can be difficult to determine if something is actually wrong. Some hematomas can seem less serious than they are until it's too late.

We're here to discuss some of the differences and similarities between a subdural vs. epidural hematoma, as well as the symptoms, risk factors, treatment methods, and outlook for both of them.

Read on to learn more.

What Is a Hematoma?

A hematoma is a pool of blood that gathers in a body space, tissue, or organ. People can experience hematomas anywhere in their bodies. They often result from injuries or trauma from accidents, falls, sports, or even surgeries.

Most hematomas go away on their own, and many are unnoticeable. However, hematomas in the brain (like subdural and epidural hematomas) do not fall into this category. They require immediate care and can be deadly otherwise.

What Is a Subdural Hematoma?

A subdural hematoma is what happens when blood collects between the middle and outer tissue layers that cover the brain.

When someone sustains cranial trauma that causes the brain to jolt or move in the skull, it tears the veins that are responsible for draining blood from the surface of the brain. In infants, a subdural hematoma can happen as a result of abuse or mistreatment, often referred to as shaken baby syndrome.

What Is an Epidural Hematoma?

Epidural hematomas are different, but similar to subdural hematomas. It also happens as a result of cranial trauma, but generally due to a skull fracture rather than the movement of the brain inside the skull.

During a skull fracture, arteries that supply blood to the brain can tear. The resulting bleeding (the epidural hematoma) can lead to quick pressure buildup in the brain, which can be incredibly dangerous.

This is more common in children and young adults than older adults.

What Causes Subdural or Epidural Hematomas?

So what is it that causes these different hematomas? While they can both result from head injuries, the specific causes vary. Here are a few risk factors and causes associated with each type of hematoma.

Subdural Hematoma

Many subdural hematomas occur after serious head injuries. Car accidents, sports injuries, and serious falls can all cause severe subdural hematomas that can become deadly if not treated right away due to the increased pressure in the brain tissue. Severe subdural hematomas move quickly.

However, it's also possible to experience a subdural hematoma after a minor injury. Chronic subdural hematomas occur after minor head injuries and the bleeding is far slower. Many people won't notice these hematomas for several days.

While injuries cause hematomas, there are also several risk factors that make someone more likely to experience one. Blood thinners, alcohol, blood clotting conditions, and repeated head injuries all make someone more susceptible to subdural hematomas.

Epidural Hematoma

Often, epidural hematomas happen as the result of head trauma during childhood or adolescence. At this stage, the thin membrane that covers the brain is still in the process of attaching to the skull. It's not yet as secure as it will be in later adulthood.

Adults can still experience epidural hematomas, but generally from more serious events and injuries. Car or motorcycle accidents, serious falls on hard surfaces, skateboard injuries, and contact sports injuries can all potentially cause epidural hematomas (among other things, of course).

Ruptured blood vessels can also result in epidural hematomas.

Subdural vs. Epidural Hematoma Symptoms

So how would one know if they were experiencing a subdural or epidural hematoma? There are a few symptoms to look out for, some more severe than others. Here's a quick breakdown of symptoms to look out for so you know when to seek medical care after a head injury.

Subdural Hematoma

Subdural hematoma symptoms vary depending on the severity of the hematoma, but even in hematomas from minor injuries, they will become apparent within a matter of days. After serious injuries, you may start noticing symptoms immediately.

Psychological symptoms include confusion, disorientation, mood changes, and even psychosis. Someone with a subdural hematoma may also experience sleepiness or fatigue.

Physical symptoms include weakness, difficulty balancing, numbness, vision problems, weakness, nausea, seizures, and loss of consciousness.

If you experience any of these symptoms after a head injury or fall, please contact a medical professional right away.

Epidural Hematoma

In general, an epidural hematoma will result in a loss of consciousness, a brief waking period, and then another loss of consciousness. There are exceptions and other symptoms, however.

People may also experience confusion, nausea, drowsiness, severe headaches, and one enlarged pupil. They may also experience seizures.

As soon as you see someone lose consciousness after a head injury, it's imperative that you find medical care. This is a sign that something is seriously wrong.

Subdural vs. Epidural Hematoma Treatment

So how does one treat a subdural or epidural hematoma? Note that for both of these conditions, medical treatment is necessary. Intracranial hematomas are life-threatening, and unlike some other types of hematomas, they will not go away on their own.

Here's a breakdown of what you can expect from hematoma treatment.

Subdural Hematoma

Subdural hematomas require treatment as quickly as possible to reduce pressure within the skull.

In some cases, doctors will prescribe diuretics and anti-seizure medications to control symptoms. The patient may need to have a hole drilled into their skull to drain excess blood and relieve pressure. For more serious cases, a craniotomy may also be necessary to remove clots.

After initial treatment, some patients benefit from physical therapy to get back to "normal." This is more common for people who experienced chronic subdural hematoma.

It is not unusual to experience seizures even months or years after the hematoma occurs. Talk to your doctor about anti-seizure medications to control this problem.

Epidural Hematoma

Again, epidural hematomas are emergency situations. Seek care immediately if you or someone you know is experiencing an epidural hematoma.

As with subdural hematoma, doctors may prescribe anti-seizure medications to control symptoms. They may also use hyperosmotic agents to reduce swelling.

The doctors will reduce swelling, again, either by drilling a hole in the skull or performing a full craniotomy.

In many cases, epidural hematoma, even with treatment, can result in death. It is imperative to seek care as soon as possible to achieve the best possible results.

Is One More Dangerous Than the Other?

Both epidural and subdural hematomas can be life-threatening.

Chronic subdural hematomas are dangerous, but less dangerous than acute subdural hematomas or epidural hematomas. The prognosis for people who experience chronic subdural hematomas is good and the recovery is generally easier.

Acute subdural hematomas often result in brain injury, and in many cases, death (even with treatment). The location and the severity of the hematoma will determine how well (or if) the patient recovers.

For epidural hematomas, the risk is sometimes greater. Even after quick treatment, patients can experience severe brain injuries and they may never recover.

Epidural hematomas are easier to diagnose but require quicker treatment. Subdural hematomas can be challenging to diagnose, but there's a bit more "wiggle room" when it comes to treatment (depending, of course, on the severity of the hematoma).

In short, both are almost equally dangerous.

Subdural vs. Epidural Hematoma: Now You Know

The differences between a subdural vs. epidural hematoma may seem slim, but they're helpful to know. If you think that you may be experiencing either type of hematoma, it's crucial to visit a medical professional right away. They'll be able to evaluate your situation so you can get the care you need.

After sustaining a TBI, the symptoms you begin to experience can be overwhelming. Sallie® aims to ease this feeling by being an incredibly easy-to-use and free symptom-tracking dashboard. Using the dashboard at the beginning of one’s recovery can help one to identify symptoms and triggers. Our robust data collection approach includes many speech symptoms for our users to track.

Identifying that you may be experiencing difficulties with seizures and other long-term effects of your injury and hematoma could be the first step towards recognizing your possible need to introduce physical therapy or prolonged medical care and Sallie® into your recovery plan.

Take hold of your brain injury recovery today! Register here for Sallie®.

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