Bleeds in the head (“intracranial bleeds”) are classifed according to location and age. Bleeding within the brain itself (intracerebral hemorrhage) is caused by AVMs in younger people, by high blood pressure or a condition called amyloid angiopathy in older people, and can result from trauma (e.g. fall, car accident) causing a “brain contusion” or bruising. Bleeding between the brain and its lining (called the dura) is called a “subdural hematoma,” due to a tear in a vein draining the brain – it is seen in people who are prone to falls, and people on blood thinners (usually elderly); subdural hematoma can also be seen following brain trauma (like car accidents) and in child abuse (“shaken baby syndrome”). A bleed between the dura lining the brain and the skull is called an “epidural hematoma” and is caused usually by a tear in an artery next to the skull (and associated with a skull fracture) – this is dangerous, because people can be “awake and fine” and then quickly worsen. “Subrachnoid hemorrhage,” bleeding into the spinal fluid, is usually caused by traumatic brain injury or aneurysm rupture (see above). Finally, bleeding outside of the skull (below the scalp, called a “cephalhematoma”) almost never requires any surgical drainage, and is absorbed generally over time. We routinely treat many of these in our practice. Please see "Treatments & Testimonials" more details on surgical treatment of bleeds.
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