Intracranial haemorrhage

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There are three layers of meninges, which lie between the brain and the bones which surround it.

  • Dura
  • Arachnoid
  • Pia

There are three sorts of intracranial haemorrhage caused by bleeding into the different spaces.

Info bulb.pngThere isn't a way there could be a "subpial" haemorrhage because no blood vessels lie between the pia and the neural tissue of the brain. (The name pia means affectionate in Greek.)

Intra-cerebral bleeds can also occur in stroke disease.

Extradural

The extradural space is a potential space. (The periosteal dura is periosteum, so it is tightly connected to the overlying bone.) However, once bleeding occurs into this space, the dura is slowly separated from the skull up to the cranial sutures. Once these are reached, the only way for the volume to increase is by impacting on the brain.

Subdural

Again this is a potential space. Haemorrhage into here is caused by a jerking movement, which is required to separate the arachnoid from the dura. The bleeding into this space is venous in origin, so the progression is slow. Often the elderly get these weeks after a trivial injury that has been forgotten. See subdural haemorrage.

Subarachnoid

This space is normally filled with CSF. Bleeding into this space is normally due to an aneurysm, in which case it is arterial in origin. See subarachnoid haemorrhage.

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