Can a Skull Fracture Cause a Subdural Hematoma?

Short answer: yes, a skull fracture can cause a subdural hematoma

If you are asking whether a subdural hematoma can be caused by a skull fracture, the answer is yes. A broken skull can tear blood vessels or injure tissue beneath it, and blood can then collect around the brain. A fracture is not required, though. Bleeding can also happen after a hard hit or sudden head movement when the skull looks intact. Many people first hear this term during an emergency visit, so the words can feel confusing. This page explains the basics in plain language. It covers how the bleed forms, how acute and chronic bleeds differ, and what Virginia law says about timing. Doctors usually use imaging, such as a CT scan, to check for both a fracture and bleeding. A fracture seen on a scan does not, by itself, show how the bleed started.

How a skull fracture can lead to bleeding under the dura

A skull fracture leads to bleeding under the dura when it tears veins or injures the surface of the brain. The dura is the tough outer membrane that wraps the brain. A subdural hematoma is a pool of blood that forms in the space just beneath it. A fracture can cause this bleeding in two main ways. It can tear small veins that cross this space, often called bridging veins. It can also injure the brain’s surface under the break. Blood then builds up in a space that has little room to spare. As the pool grows, it presses on the brain tissue beneath it. That pressure is why timing and monitoring matter. In a car accident, the head may strike the steering wheel, a window frame or the road. Those impacts can break bone and move the brain at the same time. For more on crash injuries, see the firm’s car accident page.

Subdural hematoma without a skull fracture

A subdural hematoma can also form when the skull is not broken. The brain sits loosely inside the skull, surrounded by fluid. During a sudden stop, a fast turn or a hard jolt, the brain can move quickly against the skull. Bridging veins can stretch and tear during that movement, even with no fracture. Blows that do not break bone can still injure the brain. An intact skull isn’t the same as an unharmed brain. Head trauma can also come from a fall or a violent attack, not only from a vehicle. Because the skull can look normal, anyone with new symptoms after a head impact should be checked promptly.

Acute versus chronic subdural hematoma

An acute subdural hematoma appears soon after the injury and often causes symptoms fairly quickly. A chronic subdural hematoma develops or grows slowly, and symptoms can appear well after the head injury. A person may remember a head bump that seemed minor at the time. That is one reason the timing can confuse families. A slow bleed can still be linked to the original impact. The gradual change can make it hard to connect symptoms to the earlier impact. Consider a hypothetical driver who hits the head on a window frame in a low-speed crash and feels fine that day. If worsening headaches appear a few weeks later, those symptoms can still relate to the first impact. The medical team would want to hear about the crash. Writing down the date of the head impact and the date symptoms began can help. Doctors decide on any treatment based on the scan and the person’s symptoms.

Subdural hematoma vs. subarachnoid hemorrhage

A subdural hematoma is bleeding between the dura and the arachnoid layer. The arachnoid is the middle membrane that surrounds the brain. A subarachnoid hemorrhage is bleeding in the space beneath the arachnoid layer. Both are types of intracranial bleeding, meaning bleeding inside the skull. Both can follow head trauma, which is why people often mix up the terms. They differ in where the blood sits, how it looks on imaging and what usually causes them. Doctors look at the location and shape of the blood on imaging to tell the two apart. A clinician identifies which type is present, and that finding guides the medical response. Families who hear both terms can ask the treating team to explain which one was found.

Is a subdural hematoma a traumatic brain injury?

A subdural hematoma caused by an outside force to the head is generally considered a form of traumatic brain injury. Virginia Brain Injury Services describes brain injury as damage or changes in brain function caused by an external force. The same resource states that motor vehicle accidents can cause traumatic brain injury. A brain injury diagnosis must be made by a doctor. The traumatic label refers to how the injury happened, not how serious it is. Traumatic brain injury covers a wide range of injuries, from mild to severe. After a crash, keep copies of discharge papers, scan reports and follow-up notes. They describe the injury in the medical team’s own words. The firm’s traumatic brain injury page covers this topic in more depth.

Timing, medical records and the Virginia filing deadline

Medical records help show when symptoms began and how they changed over time. Those records can show the sequence from the impact to the diagnosis. Virginia generally allows two years from the date of injury to file a personal injury lawsuit (Va. Code § 8.01-243(A)); the clock runs from the date of injury, not the date of discovery, with narrow exceptions. Va. Code § 8.01-243 sets out this rule. Virginia requires a driver involved in a crash with injury or death to stop and report it to police immediately (Va. Code §§ 46.2-371, 46.2-894). The two-year period is the deadline to file a lawsuit, not to report a crash.

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