• Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: Mary D. Nettleman, MD, MS, MACP
    Mary D. Nettleman, MD, MS, MACP

    Mary D. Nettleman, MD, MS, MACP

    Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

Quick GuideConcussions & Brain Injuries: Symptoms, Tests, Treatment

Concussions & Brain Injuries: Symptoms, Tests, Treatment

What are the different types of hematomas?

Hematomas are often described based upon their location. The most dangerous hematomas are those that occur inside the skull. Because the skull is an enclosed container, anything that takes up space increases pressure within and potentially impairs the ability of the brain to function.

What are epidural and subdural hematomas?

Epidural hematomas occur because of trauma, often to the temple, where the middle meningeal artery is located. Bleeding accumulates in the epidural space, outside the "dura" which is the lining of the brain. Because of the way the dura is attached to the skull, small hematomas can cause significant pressure and brain injury.

Subdural hematomas also occur because of trauma but the injury is usually to the veins in the brain. This causes a slower leak of blood, which enters the "subdural" space below the dura. The space below the dura has much more room for blood to accumulate before brain function suffers. As people age, they lose some brain tissue and the subdural space is relatively larger. Bleeding into the subdural space may be very slow, gradually stop, and not cause acute symptoms. These “chronic” subdural hematomas are often found incidentally on computerized tomography (CT) scans as part of a patient evaluation for confusion or because another traumatic incident occurred. However, subdural hematomas may be large, cause associated brain swelling, and may be lethal.

Reviewed on 11/4/2016
Medically reviewed by Joseph Palermo, DO; American Osteopathic Board Certified Internal Medicine


Longo, Dan, et al. Harrisons's Principles of Internal Medicine. 18th ed. McGraw-Hill, 2011.



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