Epidural hematoma

Epidural Hematoma
Specialty	Neurology, Neurosurgery, Emergency medicine
Symptoms	Headache, loss of consciousness, confusion, weakness, seizures
Causes	Head injury, vascular malformation, anticoagulation
Diagnosis	Computed tomography (CT), Magnetic resonance imaging (MRI)
Treatment	Craniotomy, Craniectomy, conservative management
Prognosis	Variable, depends on size, location, and time to treatment

Siebert 19 Epidurales Haematom

Hematoma Comparison

Grosses epidurales Haematom nach Sturz 87W - CT - 001

An epidural hematoma is a traumatic accumulation of blood between the inner table of the skull and the outer layer of the dura mater. It is often caused by head injuries that result in the rupture of the middle meningeal artery or its branches. Rapid diagnosis and treatment are crucial to prevent irreversible brain damage or death.

Signs and Symptoms

Symptoms of an epidural hematoma may include:

• Severe headache
• Loss of consciousness, followed by a lucid interval (consciousness) and then rapid deterioration
• Confusion or altered mental status
• Weakness or numbness on one side of the body
• Seizures
• Pupil dilation on the side of the hematoma

Causes and Risk Factors

• Head injury: The most common cause of an epidural hematoma is a traumatic head injury, such as a fall, motor vehicle accident, or assault. Fractures of the temporal bone are particularly associated with this condition.
• Vascular malformation: An abnormality in the blood vessels can increase the risk of bleeding.
• Anticoagulation: Use of anticoagulant medications or a coagulopathy can increase the risk of bleeding after a head injury.

Diagnosis

Diagnosis of an epidural hematoma is typically made using imaging studies:

• Computed tomography (CT): The first-line imaging modality, as it is fast and widely available.
• Magnetic resonance imaging (MRI): May be used when CT is not available or when additional information is needed.

Treatment

Treatment options for an epidural hematoma include:

• Surgical: In cases of significant hematoma or neurological deterioration, a craniotomy or craniectomy may be performed to evacuate the hematoma and relieve pressure on the brain.
• Conservative management: In cases of small or asymptomatic hematomas, close monitoring and supportive care may be sufficient.

Prognosis

The prognosis of an epidural hematoma depends on the size and location of the hematoma, the extent of the injury, and the time to treatment. Rapid diagnosis and intervention are crucial to improve outcomes.

See Also

• Subdural hematoma
• Traumatic brain injury
• Head injury
• Intracranial hemorrhage