Slow bleeding from bridging veins under low pressure, with headache, confusion, and LOC, is typical of which hematoma?

• A. Subdural hematoma
• B. Epidural hematoma
• C. Intracerebral hemorrhage
• D. Subarachnoid hemorrhage

Answer: (A)

A subdural hematoma results from tearing of bridging veins that traverse the space between the dura and the arachnoid. Because venous bleeding is slow and under lower pressure than arterial bleeding, the blood accumulates gradually, so symptoms like headache, confusion, and sometimes loss of consciousness can develop over hours to days after a minor head injury. This is especially common in older adults or those with brain atrophy, where the bridging veins are more easily stretched and torn. On imaging, the bleed forms a crescent-shaped collection that can cross suture lines, distinguishing it from an epidural hematoma, which is typically lens-shaped and due to arterial rupture. Intracerebral hemorrhage involves bleeding into brain tissue with focal deficits, and subarachnoid hemorrhage involves blood in the subarachnoid space with a sudden severe headache.