What Is an Epidural Hematoma?
An epidural hematoma occurs when blood fills the
area between the skull and the protective covering of the brain.
If the brain bounces against the inside of the
skull during a collision, it can experience tearing of the internal lining,
tissues, and blood vessels. This will result in bleeding. A mass of blood
called a hematoma may form between the skull and brain. This epidural hematoma
creates pressure on the brain.
There is no room in the skull for the brain to
expand, so the brain may shift as it swells. The brain structures push together
and create pressure, which can affect vision, speech, and consciousness. The
brain may also lose blood supply and die.
If you suspect you have an epidural hematoma,
you should get immediate medical care. Left untreated, an epidural hematoma can
cause brain damage and eventually death.
What Causes Epidural Hematomas?
hematoma typically results from trauma or injury to the head. Your brain may be
subjected to an intense, damaging blow in a fall, a vehicular accident, or a
collision during contact sports, for example.
Who Is at Risk for an Epidural Hematoma?
You are at a higher risk
for developing an epidural hematoma if you:
trouble walking without falling
experienced trauma to your head
alcohol, which can increase your risk of falls
an blood thinning medication
not wear a protective helmet during contact activities
What Are the Symptoms of an Epidural Hematoma?
Symptoms of an epidural
hematoma depend on the severity of the brain injury. A common symptom is a
brief period of unconsciousness. This is followed by a period of alert
consciousness before returning to unconsciousness or even coma.
symptoms typically occur within minutes to hours after a head injury and may
indicate an epidural hematoma:
- varying levels of alertness
- severe headache
- enlarged pupil in one eye
- weakness on one part of the body, typically on the side opposite the
- bruises around the eyes
- bruises behind the ears
- clear fluid draining from the nose or ears
- shortness of breath or other changes in breathing patterns
How Is an Epidural Hematoma Diagnosed?
A physician will conduct a neurological test if he
or she suspects an epidural hematoma. Further tests may be necessary to
determine the size and position of a hematoma. Common tests are:
- computed tomography (CT)
scan to see fine details of the brain
- magnetic resonance
imaging (MRI) to examine soft tissue
(EEG) to assess the brain’s electrical activity
- laboratory blood tests
How Is an Epidural Hematoma Treated?
Treatment for an epidural hematoma depends on the severity of the brain
injury, the presence of other injuries, and symptoms.
Your doctor may
prescribe medications to reduce inflammation and intracranial pressure during
the initial phase of treatment.
After removal of the hematoma,
your doctor may prescribe anti-seizure medications to protect against seizures.
These medications may be necessary for months or even years.
called “hyperosmotic agents,” may be prescribed to reduce brain swelling. These
drugs include mannitol, glycerol, and hypertonic saline.
Surgery is generally recommended to remove
epidural hematomas. Symptoms that indicate a need for surgery generally include:
- deterioration of brain
- hematoma thicker than
one centimeter at its thickest point
Surgery usually involves a craniotomy to open up
part of the skull. This allows the surgeon to remove the clot and reduce
pressure on the brain.
Aspiration, also called surgical drainage, can
remove an epidural hematoma without surgery. This involves cutting a small hole
in the skull to remove the clot with suction. Aspiration is effective for a
very small epidural hematoma that is not causing pressure or damage to the
Do not attempt to treat
this condition at home. If you have experienced head trauma and have any
symptoms of an epidural hematoma, seek immediate medical care.
After surgery, recovery can take time. Most
improvement will occur within the first six months after the injury. Additional
improvement may take up to two years.
Recommendations for home
recovery will likely include:
- Rest when you are tired.
a good night’s sleep.
return to normal activities.
contact and recreational sports.
- Record important
information until full memory skills return.
What Is the Outlook for an Epidural Hematoma?
prompt medical treatment, an epidural hematoma carries a high risk of death
not it is treated, an epidural hematoma also puts you at a high risk for brain
damage. Brain damage can cause many types of disabilities, which can be
permanent. You may require a rehabilitation program to deal with disabilities, such
or loss of sensation
injury and after surgery, you may experience seizures for up to two years.
Preventing Epidural Hematomas
An epidural hematoma can happen to anyone. Minimize
your risk of head injury by taking safety precautions at home, at work, and
during recreational activities. Basic recommended precautions are:
a properly fitting helmet during contact sports or activities that could result
in head injury.
use your seat belt in a motor vehicle.
children from falls and blows to the head by properly childproofing your home.