Epidural hematoma
Epidural hematoma is when bleeding occurs between the tough outer membrane covering the brain (dura mater) and the skull. When this condition occurs in the spinal canal, it is known as a spinal epidural hematoma.
| Epidural hematoma | |
|---|---|
| Other names | Extradural 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. | |
| Specialty | Neurosurgery, Neurology |
| Symptoms | Headache, confusion, paralysis |
| Usual onset | Rapid |
| Causes | Head injury, bleeding disorder, blood vessel malformation |
| Diagnostic method | Medical imaging (CT scan) |
| Differential diagnosis | Subdural hematoma, subarachnoid hemorrhage, traumatic brain injury, transient ischemic attack seizure, intracranial abscess, brain tumor |
| Treatment | Surgery (craniotomy, burr hole) |
There may be loss of consciousness following a head injury, a brief regaining of consciousness, and then loss of consciousness again. Other symptoms may include headache, confusion, vomiting, and an inability to move parts of the body. Complications may include seizures.
The cause is typically head injury that results in a break of the temporal bone and bleeding from the middle meningeal artery. Occasionally it can occur as a result of a bleeding disorder or blood vessel malformation. Diagnosis is typically by a CT scan or MRI scan.
Treatment is generally by urgent surgery in the form of a craniotomy or burr hole, or (in the case of a spinal epidural hematoma) laminotomy with spinal decompression.
The condition occurs in one to four percent of head injuries. Typically it occurs in young adults. Males are more often affected than females.