Nervous System Hemorrhage

Extraparenchymal –> outside of brain

1. Caput succedaneum = blood above the glea aproneurotica but under the scalp
2. Subgleal hemorrhage = blood under the glea aproneurotica and between the skull opening
3. Cephalohematoma = blood under the upper periosteum and above the skull
4. Epidural hematoma = blood under the lower periosteum and above the dura mater
5. Subdural hematoma = blood under the dura mater and in the arachnoid/ above the pia mater.

Intraparenchymal –> into brain

1. Subarachnoid hemorrhage = bleeding under the arachnoid membrane but above the pia mater.
2. Cerebral lobe (cortical) hemorrhage = bleeding can be in the dominant and non-dominant frontal lobes, parietal lobes, and temporal lobes or the occipital lobe. The location can be localized by knowing the deficits that occur when each region is damaged. Knowledge of the dominant hand of the person in addition to the deficit description will help determine if the dominant or non-dominant lobe is the left/ right lobe of the person.
3. Subcortical (deep brain) hemorrhage = bleeding into deep regions within the brain – particularly the basal ganglia (mainly the putamen), internal capsule, thalamus
4. Intraventricular hemorrhage = bleeding into the ventricular space where CSF is located. Seen in preterm newborns born <32 weeks gestation or very low birth weight newborns (<1500g) due to rupture of fragile capillaries in a germinal matrix that has not involuted yet.
5. Cerebellar hemorrhage = bleeding can be in the cerebellar vermis or the cerebellar hemispheres
6. Brainstem hemorrhage = bleeding can be in the midbrain, pons or medulla. The exact location can be localized by knowing the cranial nerves in the midbrain, lateral pons, medial pons, lateral medulla, and medial medulla. The vessel can be localized by knowing the blood vessels the are in each of the above locations.
7. Spinal epidural hematoma = bleeding into the spinal canal, typically seen after a procedure.