Epidural bleeding
This bleeding often occurs due to a rupture of a meningeal artery, usually caused by trauma (accident). The meningeal artery is most frequently affected. An arterial bleeding occurs between the periosteum of the skull and the dura mater.
Here an epidural space is formed which otherwise does not exist physiologically. The bleeding can cause compression of the brain tissue relatively quickly, which is often associated with the symptoms of coma. Furthermore, hemiplegia can form on the opposite side of the hemorrhage. Surgical relief of the intracranial pressure is the obligatory therapy here.
Subdural Hematoma
A subdural hematoma can occur acutely (usually due to trauma) or develop chronically over a long period of time. In this case, bleeding occurs between the dura mater and the arachnoidea and is caused by a rupture of the bridging veins. A subdural space is formed which normally does not exist.
The symptoms of acute subdural hematoma are essentially the same as those of epidural hemorrhage, and the therapy must also include surgical relief. Chronic subdural hemorrhage can cause diffuse symptoms such as increasing dizziness, headaches and clouding of consciousness over a period of weeks. Therapeutically, a small hole is usually drilled into the skull to relieve pressure.
Subarachnoiadal hemorrhage
It is caused by the rupture of vessels or vascular malformations in the region of the basilar artery. This vessel is the main arterial trunk for blood supply to the brain and is located at the base of the skull. This is where vascular bulges (aneurisms) can form, which eventually burst and lead to bleeding into the physiologically present subarachnoid space.
The location of these vessels in close proximity to the brain stem can lead to life-threatening disturbances of vital functions such as breathing and cardiovascular system, whose control centers are located there. Operationally, this area is difficult to reach. Nevertheless, depending on the severity of symptoms, surgery is the therapy of choice, since vascular aneurisms should be rendered harmless in order to minimize the risk of recurrent bleeding. Diagnostically, all types of intracerebral bleeding can be visualized and differentiated by means of MRI of the brain or computer tomography.
