EDH, SDH, SAH

Feature

Epi/Extra dural hemorrhage (EDH)

Sub dural hemorrhage (SDH)

Sub arachnoid hemorrhage (SAH)

Location

Between dura mater and skull

Between dura mater and arachnoid mater

between the arachnoid and pia mater (in subarachnoid space)

Suture line

Doen’t cross suture lines

Cross suture lines

Cross suture lines

Cause

Due to trauma causing rupture of an arterial vessel

Due to trauma causing rupture of a venous vessel

Due to trauma or aneurysm rupture causing bleeding into the cerebrospinal fluid

Vessel involved

Middle meningeal artery (MMA)

Bridging vein

Circle of willis

Rupture of berry aneurysm

Onset

Rapid, within minutes to hours

Slower, can develop over days to weeks

Sudden, within minutes

Symptoms

Headache

Loss of consciousness followed by unconsciousness (called lucid interval)

Headache

Confusion

Severe sudden headache / Thunderclap headache (often described as the worst headache ever)

Imaging Characteristics

(on CT scan)

Biconvex / lens-shaped (due to rapid expanding arterial blood)

Concave / Crescent-shaped (due to slow expanding venous blood)

Hyperdensity in the subarachnoid space (often seen around the circle of willis)

Treatment

Surgical intervention often needed (e.g., craniotomy)

May require surgical intervention or conservative management, depending on severity

Often requires immediate medical intervention, potentially including surgery, and management of complications like vasospasm

Prognosis

Can be life-threatening if not treated promptly; depends on the extent of bleeding and intervention

Variable; can range from mild to severe, with chronic cases potentially developing into a more serious condition

Can be life-threatening with significant risk of complications like vasospasm and secondary brain injury