-Intracerebral hemorrhage: bleeding inside the brain
-Subarachnoid hemorrhage: bleeding in the space between the innermost membrane covering the brain (the pia mater) and the layer immediately above it (the arachnoid membrane
-Subdural hemorrhage: bleeding between the arachnoid membrane and the outer layer of the brain's protective covering (the dura mater)
-Epidural or extradural hemorrhage: bleeding between the skull and the dura mater.
Swelling (Hydrocephalus)
The term hydrocephalus comes from two words (hydro-water,cephalus-head). Hydrocephalus is a condition in which too much cerebrospinal fluid (CSF) accumulates within the ventricles (fluid-containing spaces) of the brain. Too much CSF builds up creating pressure and damage to the brain tissue. If there is too much pressure, this can stop stuctures that control breathing or heart rate. In infants when the skull is not yet fused,the skull expands somewhat, an older childs skull is quite rigid and pressure can build up dangerously fast.
Cerebral Edema
In brain injury, the brain tissue may swell increasing the brain water content and can be either intracellular or extracellular. The brain is particularly susceptible to injury from edema, because it is located within a confined space and cannot expand and because there are no lympathic pathways within the CNS (central nervous system) to carry away the fluid.
Intracellular (Cytotoxic) edema
Cellular swelling, in the grey matter, and is usually seen following cerebral ischema caused by minor head injury. The BBB (blood brain barrier) is intact. Intracellular edema is usually not clinically significant, and is reversible in its early phases.
Extracellular (vasogenic) edema
Cellular swelling after a vascular injury, includes the white matter and disruption of the BBB. These serious conditions can eventually lead to herniation.
Brain Herniation
Brain herniation (protrusion) is a major consequence of cerebral edema.There are several types of brain herniation - classified by the part that is herniated or the structure under which it has been pushed.
- subfalcine
- transalar
- uncal
- transtentorial
- decending (anterior)
- ascending (posterior)
(Diagrams)