Intracranial hematomas

Intracranial hematomas are bad stuff that keep neurosurgeons busy. They are usually diagnosed by imaging (CT head).

Classification

1. Epidural hemorrhage (extradural hemorrhage).
   • Patient may have lucid interval.
   • Middle meningeal artery.
   • Radiology: biconvex.
2. Subdural hemorrhage
   • Damaged bridging veins: subdural space between the dura and arachnoid mater.
   • Radiology: crescent shape.
3. Subarachnoid hemorrhage.
   • Classically caused by aneuryms:
     1. Anterior communicating artery (ACA) - most common.
     2. Middle cerebral artery (MCA) - second most common.
4. Intracerebral hemorrhage.
   • > 60 ml at presentation (assessed via CT scan) assoc. with > 90% 30 day mortality.

Traumatic subarachnoid hemorrhage

• May have a characteristic mastoid contusion.
  • May be associated with vascular Ehlers-Danlos syndrome.

See also

• Forensic pathology.
• Neuropathology.