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Hemorrhagic parenchymal contusions and cerebral microhemorrhages are examples of traumatic intra-axial bleeds. [3] Extra-axial hemorrhage, bleeding that occurs within the skull but outside of the brain tissue, falls into three subtypes: epidural hematoma, subdural hematoma, and subarachnoid hemorrhage. [3]
Only 20 to 30% of epidural hematomas occur outside the region of the temporal bone. [11] The brain may be injured by prominences on the inside of the skull as it scrapes past them. Epidural hematoma is usually found on the same side of the brain which was impacted by the blow, but on very rare occasions it can be due to a contrecoup injury. [12]
Extra-axial hemorrhage, bleeding that occurs within the skull but outside of the brain tissue, falls into three subtypes: Epidural hemorrhage (extradural hemorrhage) which occur between the dura mater (the outermost meninx) and the skull, is caused by trauma.
Axial CT scan showing hemorrhage in the posterior fossa [22] Intracerebral bleeds are the second most common cause of stroke, accounting for 10% of hospital admissions for stroke. [23] High blood pressure raises the risks of spontaneous intracerebral hemorrhage by two to six times. [22]
Between them is the epidural space. The two layers of the dura mater separate at several places, with the meningeal layer projecting deeper into the brain parenchyma forming fibrous septa that compartmentalize the brain tissue. At these sites, the epidural space is wide enough to house the epidural venous sinuses. [2] [4] [5]
Clinical manifestations of intraparenchymal hemorrhage are determined by the size and location of hemorrhage, but may include the following: [citation needed] Hypertension, fever, or cardiac arrhythmias
The symptoms of a subdural hematoma have a slower onset than those of epidural hematomas because the lower-pressure veins involved bleed more slowly than arteries. Signs and symptoms of acute hematomas may appear in minutes, if not immediately, [ 5 ] but can also be delayed as much as two weeks. [ 6 ]
Cerebral contusion (Latin: contusio cerebri), a form of traumatic brain injury, is a bruise of the brain tissue. [2] Like bruises in other tissues, cerebral contusion can be associated with multiple microhemorrhages, small blood vessel leaks into brain tissue.