Extradural haemorrhage (venous)

A.Prof Frank Gaillard et al.

Venous extradural haemorrhages are a relatively uncommon and subtype of arterial extradural haemorrhages differing not only in aetiology but also location and prognosis. 

They occur as a result of damage to the dural venous sinuses and often result in the displacement of the sinus away from the underlying bone. 

For a general discussion, including epidemiology, clinical presentation, pathophysiology and general imaging appearances, please refer to the article on extradural haemorrhage

Location

Three locations are characteristic of venous extradural haemorrhage:

  1. vertex
  2. anterior middle cranial fossa
  3. occipital posterior fossa
Vertex

Extradural haemorrhages located at the vertex are usually due to diastasis +/- fracture involving the superior sagittal sinus. Venous blood from the sinus or closely associated vein accumulates between the endosteal layer of the dura and the overlying inner table of the skull. Because the sinus runs in line with the disrupted sagittal suture, this is one of the occasions when an extradural haematoma crosses the suture and in so doing displaces the superior sagittal sinus inferiorly. 

Anterior middle cranial fossa

Anterior middle cranial fossa extradural haemorrhages are thought to arise from the sphenoparietal sinus which runs along the superior margin of the greater wing of sphenoid 1. Due to their location, the anatomy of dural attachments and venous origin, they do not cause midline shift or herniation, rarely grow, and can generally be managed conservatively 1

Occipital posterior fossa

Although most extradural haematomas in the posterior fossa are due to temporal bone fractures involving the middle meningeal artery, in the setting of occipital trauma, particularly fractures of the occipital bone, venous haemorrhage is more common 2. As is the case with vertex extradural haemorrhages, bleeding is from the adjacent sinus, in this case, the transverse sinus, which can be elevated away from the underlying bone. 

Stroke and intracranial haemorrhage
Share article

Article information

rID: 55508
Synonyms or Alternate Spellings:
  • Extradural haematoma (venous)
  • Extradural hemorrhage (venous)
  • Venous extradural hemorrhage
  • Venous extradural haematoma
  • Venous extradural hematoma
  • Venous extradural haemorrhage

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    Case 1: vertex EDH
    Drag here to reorder.
  • Drag
    Case 1: associated fracture
    Drag here to reorder.
  • Drag
    Case 2: anterior middle cranial fossa EDH
    Drag here to reorder.
  • Drag
    Case 4: occipital EDH
    Drag here to reorder.
  • Drag
    Case 5: occipital EDH
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.