hello in this video we're going to talk about intracranial hemorrhage now intracranial hemorrhage um is a broad term because there are different types of hemorrhages that can occur within the skull and so you can divide these types of hemorrhages in broadly into extra axial Hemorrhage meaning outside the brain tissue and then you have intraaxial Hemorrhage which is within the brain tissue itself some examples of extra axial Hemorrhage include epidural subdural and subarachnoid hemorrhages and then examples of intraaxial hemorrhage meaning hemorrhages that occur within the brain tissue include intracerebral Hemorrhage and intraventricular Hemorrhage so now let's look at these different types of hemorrhages let's begin by first looking at the extra axial Hemorrhage and again the definition is B ing that occurs within the skull but outside the brain tissue so let's look at the first example which is epidural an epidural Hemorrhage is a hemorrhage that occurs um essentially between the skull and the Dural membrane so here I am drawing a cross-section if you're look if you're looking straight at ah head we're cutting a section um right right through the head and we can see obviously the brain inside there with the brain stem and the cerebellum now epidural Hemorrhage occupies the space between the scub skull and the Dural membrane so let's just revise the lay layers of the cranium now so the layers of the cranium from the top is the scalp which is you know your skin um subcutaneous fat Etc and then you have the bone itself and then you have the jamata the arachnoid membrane the AR space the Pia matter and then you have the brain tissue itself so again an epidural Hemorrhage occurs within the juram mat the juram membrane and the bone epidural Hemorrhage often um is a result of a trauma to the head and so about 70 to to 70 to 95% of epidural hemorrhages um present with skull fractures as well some examples some causes of epidural Hemorrhage include motor vehicle accidents Falls and assault such as um you know a trauma to the Head now just to give some more information on epidural hemorrhages the bleeding occurs uh between the jamata and the skull the source of the blood itself is most often arterial for example from the middle menal artery clinical manifestations of an epidural Hemorrhage include altered state of consciousness headache vomiting confusion and seizures as well as Aphasia so that was epidural Hemorrhage now the next one is subdural Hemorrhage and as the name suggest suggests it's a hemorrhage that occurs below the durata so we're doing the same diagram and we're zooming into this section here and essentially the Hemorrhage occurs between the jamata and the aroid membrane the causes of subdural Hemorrhage are similar they include motor vehicle accidents Falls and assaults now some more information on subdural Hemorrhage bleeding is between the Jura and the arachnoid membrane the source of blood is often tearing of the bridging veins so the source of blood is from the veins clinical manifestation of subal Hemorrhage are similar to those of epidural Hemorrhage coma occurs in 50% of cases usually they have lucid interval which then leads to a progressive neuro Decline and then coma the final type of extra aial Hemorrhage is a subarachnoid hemorrhage and as a name suggests it's within the subarid space and usually because it occurs in the sub renoid space the blood occupies the whole area so it can actually engulf the whole brain in a way so if we zoom into this area we can see that the Hemorrhage is within the subarachnoid space and it's often a result of the cerebral artery specifically um an aneurysm within the artery so the most common cause is rupture of a sacular type of aneurysm and this would lead to a subid hemorrhage a secular H secular um aneurism is a essentially where you get this sack looking thing uh coming off the archery and this explodes resulting in Hemorrhage of course there are non aneurismal subid Hemorrhage but we won't talk about that but it's just important to note now some more information on subarachnoid hemorrhage again bleeding occurs within the arachnoid space source of blood is from rupturing of an aneurysm and most common is the cerebral arteries the clinical manifestation of subid hemorrhage is similar to those that I mentioned earlier however one key point to make is that subarid Hemorrhage often um occurs with a sudden severe headache thunder clap headache there's obviously also loss of consciousness Consciousness and potentially seizure nausea vomiting and meningismus which is essentially a Triad of symptoms relating to um irritation of the meninges this include a um stiff neck photophobia and one other thing which I cannot remember so those were the three types of extra axial Hemorrhage epidural subdural and subarachnoid now let's look at extra axial Hemorrhage which as I mentioned in the beginning of the video is hemorrhage that occurs within the brain tissue so an example is intracerebral hemorrhage and some more some sub examples are Loba Hemorrhage so Hemorrhage that occurs in specific loes of the brain you can have thalamic Hemorrhage so Hemorrhage that occurs within the thalamus and then you can have pontine Hemorrhage Hemorrhage that occurs in the ponds and also cerebella Hemorrhage in the um cerebellum so some more information on intra cerebral hemorrhage is that intracerebral hemorrhages is the second most common cause of stroke the first most common cause of stroke is um embolis or thrombus formation arthrosclerosis the causes of int seral Hemorrhage include hypertension embolism uh brain tumor bleeding disorders and drug use clinical manifestations um are include you the person possibly gets neurological signs and symptoms depending on the area affected headache nausea vomiting and decreased level of Consciousness now it's very important to realize that depending on where the Hemorrhage occurs so for example the pwns this would result in some serious neurological signs and symptoms include problems with respir uh breathing as well as heart rate because uh it's this area including the medala where our respiratory and cardiovascular centers are located so you know so depending on where the Hemorrhage occurs that is where you'll get the neurological signs and symptoms now the other type of intraaxial hemorrhage which is basically within the brain tissue is intraventricular hemorrhages and essentially it's bleeding within the ventricles of the brain so bleeding is confined to The ventricle system of the brain it's most often occurs as a secondary phenomenon when intracerebral Hemorrhage ruptures or when subarachnoid hemorrhage extends to the ventricles so essentially intraventricular Hemorrhage is secondary to another Hemorrhage such as such as a subid hemorrage or a intracerebral hemorrhage so I hope this video made sense just to recap intracranial hemorrhage includes hemorrhages that occur outside the brain tissue and hemorrhages that occur within the brain tissue some examples include epidural subdural subaco Hemorrhage and then you also have intracerebral and intraventricular Hemorrhage thank you for watching I hope you enjoy this video bye