Epidural hematoma, sometimes called extradural hematoma, is a a traumatic accumulation of blood between the inner surface of the skull and the the stripped-off dural membrane (dura mater). Often epidural hematomas are associated with the history of trauma and the fracture of the skull, and are typically seen in younger people who have suffered head trauma. About 15-20% of epidural hematomas are fatal. Unlike subdural hematoma, where it is difficult to clearly detect head trauma, extradural bleeds are usually defined by head trauma.
As many as 10-20% of all patients with head injuries are estimated to have EDH, the incidence of which is proportionate to age in the pediatric population.
Because the underlying brain has usually been minimally injured, prognosis is excellent if treated aggressively.
lethargy
headache
nausea or vomiting
head injury or trauma followed by loss of consciousness, a period of alertness, then rapid deterioration back to unconsciousness
confusion
seizures
unequal pupil size
changes in breathing
drowsiness or loss of alertness
If a doctor suspects a person has an EDH, they will do a CT scan, MRI, or an electroencephalogram and based on them surgery may be performed. Surgeons treat EDH by removing the clot to lower pressure on the brain and stopping bleeding to prevent the hematoma from returning.
Medication such as hyperosmotic agents may be presribed to help reduce inflammation and swelling in the brain. These include mannitol, glycerol, and hypertonic saline.
