EDH, SDH, SAH

Feature

Epi/Extra dural hemorrhage (EDH)

Sub dural hemorrhage (SDH)

Sub arachnoid hemorrhage (SAH)

Location

b/w dura mater & skull

b/w dura mater & arachnoid mater

b/w arachnoid & pia mater
(in subarachnoid space)

Suture

line

Doen’t cross suture lines

Cross suture lines

Cross suture lines

Cause

Due to trauma causing rupture
of an arterial vessel

Due to trauma causing rupture
of a venous vessel

Due to trauma or aneurysm rupture
causing bleeding into CSF

Vessel

involved

Middle meningeal artery
(MMA)

Bridging vein

- Circle of willis

- Rupture of berry aneurysm

Onset

Rapid, within minutes
to hours

Slower, can develop over
days to weeks

Sudden, within minutes

Symptoms

- Headache

- Loss of consciousness

followed by unconsciousness

(called lucid interval)

- Headache

- Confusion

Severe sudden headache / Thunderclap
headache (often described as the worst
headache ever)

CT scan

Biconvex / lens-shaped

(due to rapid expanding arterial
blood)

Concave / Crescent-shaped

(due to slow expanding venous blood)

Hyperdensity in the subarachnoid space

(often seen around the circle of willis)

Treatment

Surgical intervention often
needed (e.g., craniotomy)

May require surgical intervention

or conservative management,
depending on severity

Often requires immediate medical intervention,
potentially including surgery, and management of
complications like vasospasm