What is the difference between epidural hematoma and subdural hematoma?

When it comes to the difference between epidural hematoma and subdural hematoma, many people may not understand it. Subdural hematoma is one of the common intracranial hematomas, which can cause symptoms such as headache, vomiting, and papilledema, and can pose a great threat to the patient's life.

1. Subdural hematoma is closely related to craniocerebral trauma, especially acute and subacute subdural hematoma, and clinical symptoms often appear several hours or days after the injury. Chronic subdural hematomas often develop symptoms more than 2 weeks after the injury. Some patients have no obvious history of trauma, and some cases may be caused by severe coughing, vascular defects, and coagulation disorder. Acute and subacute subdural hematoma are closely related to trauma and are often difficult to misdiagnose. Chronic subdural hematoma is often not diagnosed in time, which leads to delayed treatment.

2. The clinical manifestations of subdural hematoma are mainly increased intracranial pressure, such as headache, vomiting, papilledema, impaired consciousness, etc.

The clinical manifestations of subdural hematoma patients of different ages may have their own characteristics. In young and middle-aged people, the compression of hematoma may cause obstruction of cerebral venous return, resulting in cerebral edema and symptoms of intracranial hypertension. For elderly patients, the symptoms of intracranial hypertension are relatively mild due to the relatively increased space between the skull and the brain caused by brain atrophy. Patients with arteriosclerosis are prone to neurological and psychiatric symptoms.

3. Patients with chronic subdural hematoma often forget the history of minor head trauma. Clinically, they only have increased intracranial hypertension, and localized brain dysfunction appears later. Therefore, diagnosis is often difficult and easily misdiagnosed as a brain tumor.

4. The treatment of subdural hematoma is mainly to eliminate the hematoma and remove the cyst wall to facilitate the reduction of the compressed brain tissue. Therefore, the earlier the surgery is performed, the less pressure on the brain tissue and the faster the brain function recovers. Therefore, early diagnosis of subdural hematoma is crucial.

5. Epidural hematoma occurs in the epidural space, between the skull and the dura mater. It accounts for about 30-40% of traumatic intracranial hematomas, mainly occurs acutely, accounting for about 86%, and is sometimes complicated by other types of hematomas. It usually occurs at or near the point of application and is often accompanied by fractures. It is common in young and middle-aged people, and the incidence is lower in people aged ≥ 60 years or ≤ 2 years. Three-quarters of epidural hematomas are caused by damage to the middle meningeal artery due to fractures, followed by damage to the venous sinuses, cerebral veins, and emissary veins. Therefore, the location of the hematoma can be determined based on where the fracture line passes through the meningeal vessels and venous sinuses. Therefore, the most common site for epidural hematoma is the temporoparietal region, followed by the frontoparietal parasagittal sinus. It can be unilateral or bilateral, mostly single, and multiple is rare.