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Epidural vs Subdural Hematoma in Children: What’s the Difference?

Significant head injuries are relatively common among children. Subdural and epidural hematomas are two types of intracranial bleeding that can occur due to a head injury. Read on to learn everything you need to know about epidural and subdural hematomas, including ways to treat both types. 

Epidural vs subdural hematoma

What is epidural hematoma?

An epidural hematoma is a serious condition that can be caused by a skull fracture. It refers to bleeding between the brain’s outer covering (dura mater) and the inside of the skull. Blood collects and puts pressure on the brain. This condition is a medical emergency.

This bleeding occurs when a blood vessel between the dura mater and the skull breaks. These blood vessels are often torn when a person fractures their skull.

An epidural hematoma is a serious condition that can be caused by a skull fracture. It refers to bleeding between the brain’s outer covering (dura mater) and the inside of the skull.

This bleeding is very dangerous because the blood doesn’t have anywhere to go. It builds up between the dura mater and the inside of the skull, putting pressure on the brain. This pressure can be very dangerous. When the brain or spinal cord is compressed by blood, important structures can be damaged. The pressure can also cut off the brain’s blood supply. 

Without prompt medical attention, these injuries have a high risk of death. Even with prompt treatment, an epidural hematoma could result in permanent disability.

What is subdural hematoma?

Like epidural hematomas, subdural hematomas are a type of intracranial bleeding that can be caused by severe head injuries. The difference between a subdural and an epidural hematoma is where the bleeding occurs. Subdural hematomas refer to bleeding between the dura mater, the tissue that covers the brain, and the surface of the brain. This bleeding happens when the blood vessels in the area tear. 

There are three types of subdural hematomas, and all of them are medical emergencies.

  • Acute subdural hematomas, the most dangerous kind, are usually caused by severe head injuries. Kids with these injuries usually have symptoms right away.
  • Subacute subdural hematomas may not develop until days or weeks after an injury.
  • Chronic subdural hematomas are caused by less severe head injuries. These hematomas can take weeks or months to appear, so by the time a child shows symptoms, they might not even remember how they injured their head. 

All three types of subdural hematomas are medical emergencies, so it’s important to seek medical attention for your child as soon as symptoms appear. The prognosis varies based on the type of hematoma. Chronic subdural hematomas have a lower rate of brain injury and death than acute subdural hematomas. 

Causes of epidural and subdural hematomas in children

Head injuries are the most common causes of epidural and subdural hematomas. Significant head injuries are common among kids and can be caused by car accidents, sports injuries, falls, and other accidents. 

Typically, intracranial bleeding is the result of a head injury. Severe injuries are often responsible, but it’s possible for minor head injuries to cause intracranial bleeding. Unfortunately, significant head injuries aren’t rare. In a study performed in 2016, research showed that among children 3 to 17 years old, 8.3 percent of boys and 5.6 percent of girls had suffered a significant head injury during their lifetime. As kids get older, they’re more likely to have experienced this injury. A whopping 11.7 percent of children between 15 and 17 years old are reported to have had a significant head injury. 

Head injuries are the most common causes of epidural and subdural hematomas. Significant head injuries are common among kids and can be caused by car accidents, sports injuries, falls, and other accidents.

Children can injure their heads in many ways. Car accidents, whether as a passenger or a pedestrian, are a common cause of head injuries in kids. Sports injuries, bicycle accidents, and falls are other common causes. In some cases, kids’ head injuries are caused by assault or child abuse. 

The signs of epidural and subdural hematomas in children

Since these head injuries are medical emergencies, it’s important for parents to know what signs to watch out for. The symptoms may vary depending on whether it is an epidural or subdural hematoma as well as its size and location. 

After a head injury, some people may lose consciousness, wake up, and then lose consciousness again. This symptom pattern is a classic sign of an epidural hematoma. If your child loses consciousness after a head injury, even if it’s just for a moment, seek medical attention. 

The symptoms of subdural hematomas can vary depending on the amount of bleeding and the area of the brain that’s affected.

This pattern doesn’t occur in everyone with an epidural hematoma. Some other symptoms to watch out for include a severe headache, confusion, dizziness, and nausea or vomiting. Kids with this injury could also be drowsy or less alert than normal. An enlarged pupil in one eye may be a sign of an epidural hematoma. Weakness in part of the body is another warning sign. These symptoms will usually start in the minutes and hours after a head injury. 

The symptoms of subdural hematomas can vary depending on the amount of bleeding and the area of the brain that’s affected. Like epidural hematomas, they can cause headaches, loss of consciousness, confusion, weakness, nausea, and vomiting. Other possible symptoms include vision problems, slurred speech, and balance problems. 

Ways to treat epidural and subdural hematomas in children

Epidural and subdural hematomas are medical emergencies, and prompt treatment is essential. The specific treatment offered to a child will vary based on the type of hematoma they have. Emergency surgery is often required, and doctors may also need to prescribe medication. 

Doctors may prescribe medication to help control swelling, such as diuretics or corticosteroids. When seizures are a concern, doctors may prescribe anti-seizure medication.

In both epidural and subdural hematomas, the collection of blood can put pressure on the brain, resulting in damage. Emergency surgery may be needed to reduce this pressure. Surgeons may need to drill a hole in the skull to let the blood drain out. Sometimes, they need to make a larger opening in the skull through a procedure called a craniotomy. Surgeons may perform this procedure in children who have large hematomas. Surgeons may also use this procedure to remove solid blood clots.

A variety of medications may be needed after surgery. Doctors may prescribe medication to help control swelling, such as diuretics or corticosteroids. When seizures are a concern, doctors may prescribe anti-seizure medication.

Taking care of your child after surgery

After surgery, children who’ve had a subdural or epidural hematoma need time to recover. Some children start to feel better within a few weeks, while others need more time. Home care, physical therapy, and medications are some of the treatments that physicians may recommend during the recovery period. 

After surgery, some children start to feel better within a few weeks, while others need more time.

Children who’ve had surgery to remove a subdural or epidural hematoma won’t feel better right away. It can take weeks or months for some people to feel better. The greatest period of recovery is up to three months after the injury. If neurological problems continue, a child might need occupational and/or physical therapy. 

Doctors may recommend home care for kids who are recovering from these injuries, such as getting rest. This includes resting the brain, so parents may need to keep their kids away from distractions like gaming consoles and televisions. 

Doctors often recommend that children avoid contact sports during recovery. They can gradually increase their activity level as their brains recover, and eventually, they may be cleared to return to their favorite sports.

Physical therapists can teach children exercises that can help them regain their physical abilities. This treatment might help kids manage paralysis, weakness, or other lingering physical problems.

Some children may need physical therapy after a brain injury. Physical therapists can teach children exercises that can help them regain their physical abilities. This treatment might help kids manage paralysis, weakness, or other lingering physical problems caused by their injury.

While children are recovering from surgery, they may need to take prescription medications. For example, doctors might prescribe anti-seizure medications. Some people need to take these medications for years after the injury.

Ways to prevent hematomas

While not all head injuries are preventable, there are steps parents can take to minimize the likelihood of a head injury. Helmets and seatbelts can help protect children of all ages, and babyproofing your house can help keep younger children safe around the home. 

To prevent or minimize head injuries, parents should make sure their children wear helmets during any activity that could lead to a head injury. These activities include contact sports, bicycling, skating, snowboarding, and skiing. The helmet should be properly fitted and appropriate for the activity. 

Car accidents are one of the most common causes of head injuries in kids, so to keep your kids safe, always buckle their seatbelts. If your child isn’t big enough to use a regular seatbelt, make sure they have a car seat or booster seat that’s appropriate for their age, height, and weight. 

To prevent or minimize head injuries, parents should make sure their children wear helmets during any activity that could lead to a head injury.

Young children that have learned to stand or walk may injure themselves around the house, but babyproofing your home can help prevent these injuries. Install pads on countertops, table edges, and other hard surfaces that could injure a child’s head. Block stairways to prevent falls. Anchor heavy furniture such as dressers to the wall to prevent tipping accidents. 

When to see your child’s healthcare provider

Epidural and subdural hematomas can be life threatening, so if you think your child has had one of these injuries, seek medical care for them immediately. Since signs aren’t always immediately noticeable, keep an eye on your child if they suffer a head injury, even if they seem fine. 

If your child hits their head, watch them closely for any physical or mental changes. If symptoms occur in the days and weeks after the injury, seek medical attention right away.

If your child shows any signs of an epidural or subdural hematoma after a head injury, seek medical attention immediately. Some of these signs include a persistent headache, loss of consciousness, vomiting, and weakness.

These signs don’t always appear right after a head injury. If your child hits their head, watch them closely for any physical or mental changes. If symptoms occur in the days and weeks after the injury, seek medical attention right away.

Conclusion

Significant head injuries are common among kids, and they may result in intracranial bleeding. Parents should take steps to protect their kids from head injuries. To learn more about epidural and subdural hematomas, talk to your child’s pediatrician.

https://www.cdc.gov/nchs/products/databriefs/db302.htm

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https://www.mayoclinic.org/diseases-conditions/intracranial-hematoma/symptoms-causes/syc-20356145

https://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families.aspx

https://www.stanfordchildrens.org/en/topic/default?id=head-injury-in-children-90-P02604

https://www.nhs.uk/conditions/subdural-haematoma/recovery/

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