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Epidural, subdural, and subarachnoid hemorrhages are best understood by reviewing the
anatomy of the meninges (membrane coverings of the brain):
The meninges are divided into three layers: the dura mater, arachnoid, and pia mater. The
outer layer, the dura mater, lines the inner surfaces of the skull and forms several reflections
that partially separate the cerebral hemispheres along the midline (interhemispheric fissure)
and the cerebrum from the cerebellum. The dura mater is rather firmly adherent to the skull,
particularly at the junctions (cranial sutures) of the various bones which comprise the skull.
The potential space between the skull and the dura mater is referred to as the epidural
space. A hemorrhage into this space is referred to as an epidural hemorrhage. These
hemorrhages are usually the result of a tear in a meningeal artery.
The middle layer of the meninges is the arachnoid. It is a thin membrane likened in
appearance to a spider's web. Under normal conditions, the arachnoid is attached to the
overlying dura. The potential space between the dura mater and the arachnoid is the
subdural space. A hemorrhage into this space is referred to as a subdural hemorrhage. These
hemorrhages are usually the result of a tear in one of the small veins which traverses the
space between the brain and the dura mater (bridging veins).
Finally, the pia mater is the innermost layer. It is delicate and intimately adherent to the
surface of the brain. The space between the arachnoid and the pia mater is the subarachnoid
space. A hemorrhage into this space is referred to as a subarachnoid hemorrhage.