From the Research
Blood between the outer layer of dura and the skull is an epidural hematoma, as this type of bleed occurs in the potential space between the dura mater (the outermost meningeal layer) and the inner surface of the skull. Epidural hematomas are typically caused by trauma that tears the middle meningeal artery, resulting in arterial bleeding that rapidly accumulates and creates pressure on the brain. This condition is a medical emergency requiring prompt neurosurgical intervention. The classic clinical presentation involves a brief loss of consciousness followed by a lucid interval, then deterioration with headache, vomiting, and decreasing level of consciousness. On CT imaging, epidural hematomas appear as lens-shaped or biconvex hyperdense collections adjacent to the skull. The arterial source of bleeding explains why epidural hematomas can expand quickly, potentially leading to brain herniation and death if not treated urgently, as seen in studies such as 1.
Some key points to consider in the management of epidural hematomas include:
- The need for prompt neurosurgical intervention to prevent further brain damage and death
- The use of CT imaging to diagnose and monitor the size and location of the hematoma
- The potential for arterial embolization to stabilize the size of the hematoma, as discussed in 1
- The importance of close monitoring of the patient's neurological status and vital signs, as changes can indicate the need for urgent intervention
It is also important to note that other types of intracranial hemorrhages, such as subdural hematomas, have different characteristics and management strategies, as discussed in studies such as 2 and 3. However, these are not relevant to the specific question of blood between the outer layer of dura and the skull. Additionally, some studies, such as 4, are not relevant to the topic of intracranial hemorrhages and can be ignored in this context.