Epidural hematoma

Epidural hematoma
Other namesExtradural hematoma, epidural hemorrhage, epidural haematoma, epidural bleeding
Epidural hematoma as seen on a CT scan with overlying skull fracture. Note the biconvex shaped collection of blood. There is also bruising with bleeding on the opposite side of the brain.
SpecialtyNeurosurgery, Neurology
SymptomsHeadache, confusion, paralysis[1]
Usual onsetRapid[2]
CausesHead injury, bleeding disorder, blood vessel malformation[1]
Diagnostic methodMedical imaging (CT scan)[1]
Differential diagnosisSubdural hematoma, subarachnoid hemorrhage, traumatic brain injury,[1] transient ischemic attack seizure, intracranial abscess, brain tumor[3]
TreatmentSurgery (craniotomy, burr hole)[1]

Epidural hematoma is when bleeding occurs between the tough outer membrane covering the brain (dura mater) and the skull.[4] When this condition occurs in the spinal canal, it is known as a spinal epidural hematoma.[4]

There may be loss of consciousness following a head injury, a brief regaining of consciousness, and then loss of consciousness again.[2] Other symptoms may include headache, confusion, vomiting, and an inability to move parts of the body.[1] Complications may include seizures.[1]

The cause is typically head injury that results in a break of the temporal bone and bleeding from the middle meningeal artery.[4] Occasionally it can occur as a result of a bleeding disorder or blood vessel malformation.[1] Diagnosis is typically by a CT scan or MRI scan.[1]

Treatment is generally by urgent surgery in the form of a craniotomy or burr hole,[1] or (in the case of a spinal epidural hematoma) laminotomy with spinal decompression.

The condition occurs in one to four percent of head injuries.[1] Typically it occurs in young adults.[1] Males are more often affected than females.[1]

  1. ^ a b c d e f g h i j k l m Ferri, Fred F. (2016). Ferri's Clinical Advisor 2017 E-Book: 5 Books in 1. Elsevier Health Sciences. p. 441. ISBN 9780323448383.
  2. ^ a b Pooler, Charlotte (2009). Porth Pathophysiology: Concepts of Altered Health States. Lippincott Williams & Wilkins. p. 1256. ISBN 9781605477817.
  3. ^ Khairat, Ali; Waseem, Muhammad (2018), "Epidural Hematoma", StatPearls, StatPearls Publishing, PMID 30085524, retrieved 2019-02-13
  4. ^ a b c Pryse-Phillips, William (2009). Companion to Clinical Neurology. Oxford University Press. p. 335. ISBN 9780199710041. Epidural hemorrhage (epidural hematoma, extradural hemorrhage, or hematoma) Bleeding outside the outermost layer of the dural mater, which is thus stripped away from the inner table of the skull or spinal canal.

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