Stephen J. Schueler, M.D.

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Cerebral Subdural Hematoma Anatomy

To better understand subdural hematoma, it helps to understand the anatomy of the brain.

The dura is one of three layers of tissue that cover the brain. Bleeding from blood vessels underneath the dura can cause a collection of blood called a subdural hematoma.

Brain Anatomy
The brain is well protected by:

  • The scalp
  • The skull
  • The dura
    • A tough 3-layer sheath that surrounds the brain and spinal cord
    • Layers include the dura mater (strongest layer), arachnoid mater (middle layer), and pia mater (closest to the brain)

The brain is a complicated structure containing many parts. These include:
  • The cerebrum:
    • Made up of two cerebral hemispheres that are connected in the middle
    • It is the largest part of the brain
    • Each area of the cerebrum performs an important function, such as language or movement
    • Higher thought (cognition) comes from the frontal cortex (front portion of the cerebrum)
    • Outside of the cerebrum are blood vessels
    • There are fluid-filled cavities and channels inside the brain
  • The cerebellum:
    • Located in the lower, back part of the skull
    • Controls movement and coordination
  • The brainstem and pituitary gland:
    • Responsible for involuntary functions such as breathing, body temperature, and blood pressure regulation
    • Pituitary gland is the "master gland" that controls other endocrine glands in the body, such as the thyroid and adrenal glands
  • The cranial nerves:
    • Twelve large nerves exit the bottom of the brain to supply function to the senses such as hearing, vision, and taste
  • The cerebral blood vessels:
    • A complicated system that supplies oxygenated blood and nutrients to the brain

The blood supply to the brain is divided into two main parts:
  • Anterior cerebral circulation:
    • The front of the brain is supplied by the paired carotid arteries in the neck.
  • Posterior cerebral circulation:
    • The back portion of the brain is supplied by the paired vertebral arteries in the spine.

Anatomy examples:
  • Carotid artery branches shown on arteriogram
  • Cerebral arteries viewed in cross-section through middle of brain
  • Cerebral arteries viewed from bottom of brain
  • Cerebral arteries on enhanced CT scan
  • Cerebral arteries on arteriogram

Last Updated: Jan 5, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Cerebral Subdural Hematoma References
  1. Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, Servadei F, Walters BC, Wilberger JE; Surgical Management of Traumatic Brain Injury Author Group. Surgical management of acute subdural hematomas. Neurosurgery. 2006 Mar;58(3 Suppl):S16-24; discussion Si-iv. [16710968]
  2. Jayawant S, Parr J. Outcome following subdural haemorrhages in infancy. Arch Dis Child. 2007 Apr;92(4):343-7. [17376941]
  3. Provenzale J. CT and MR imaging of acute cranial trauma. Emerg Radiol. 2007 Apr;14(1):1-12. Epub 2007 Feb 22. [17318483]
  4. Walker RA, Wadman MC. Headache in the elderly. Clin Geriatr Med. 2007 May;23(2):291-305, v-vi. [17462518]
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