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Epidural Hematoma

An epidural hematoma is traumatic accumulation of blood due to rupture of a blood vessel, usually an artery, between the inside of the skull and the outer covering of the brain (called the "dura"). This epidural hematoma creates pressure on the brain. It is an emergency condition that may get worse very quickly within minutes to hours and can lead to permanent brain damage and death if left untreated.

Causes of epidural hematoma

  • An epidural hematoma is often caused by skull fracture that may have occurred due to a severe head injury or trauma, such as those caused by a fall, motorcycle or automobile accidents or collision. This fracture could result in tearing of affected vessel and bleeding.
  • This type of bleeding is more common in young people as compared to older people.
  • It can also occur in young children due to bleeding from a vein.

Risk factors of epidural hematoma

Following individuals are at a higher risk for developing an epidural hematoma:

  • Elderly
  • Individuals who fall frequently while walking
  • Previous trauma to head
  • Excessive alcohol intake
  • Taking blood thinning medication
  • Drive without protective helmet

Symptoms of epidural hematoma

Upon accumulation of blood inside the brain, brain structures push together and create pressure. This can happen immediately after trauma or long after trauma. The main symptoms of epidural hematoma include the following:

  • Loss of consciousness, followed by alertness, then loss of consciousness again
  • Affect vision & speech
  • Confusion
  • Dizziness
  • Drowsiness
  • Altered level of alertness
  • Enlarged pupil in one eye
  • Severe headache
  • Nausea or vomiting
  • Seizures
  • Breath shortness
  • Difficulty breathing
  • Damage to brain function
  • Weakness or loss of movement in the opposite side of body from the side with the enlarged pupil
  • Coma
  • Death

Diagnosis of epidural hematoma

The diagnosis of epidural hematoma requires thorough physical and neurological examination along with a head CT, MRI and electroencephalogram (EEG). The examination may indicate non-working part of the brain or raised intracranial pressure.

Treatment of epidural hematoma

It is an emergency condition in which treatment is done with an aim to save patient’s life, control symptoms and minimize or prevent any damage to the brain. The treatment includes:

  • Life support measures
  • Emergency surgery
  • Aspiration, also called surgical drainage
  • Craniotomy
  • Medications to control symptoms and brain damage
  • Anticonvulsant medicationsHyperosmotic agents



Authored by Dr. Shyam Sundar K

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Dr. Shyam Sundar K

Dr. Shyam Sundar K is an eminent name in the field of neurology. He is one of the best neurosurgeon in Chennai, Tamil Nadu

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