Epidural hematoma

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Epidural hematoma develops if a mass of blood forms in the area amidst the skull and protective covering of the brain. Head injuries can cause the brain to bounce within the skull. This can lead to tearing of the internal lining of the brain, blood vessels and tissues which results to bleeding, thus allowing a hematoma to form.

The presence of an epidural hematoma can place pressure on the brain and cause it to swell. As a result, the brain might move within the skull. The pressure and damage on the tissues can disrupt speech, vision, movement and consciousness. If not treated, the hematoma can cause permanent damage to the brain and even death.

What are the signs?

The signs of an epidural hematoma are based on its seriousness. It usually forms in minutes or hours after sustaining a head injury. An epidural hematoma is likely if the following are present:

  • Severe headache
    Shortness of breath or other changes in the breathing pattern.
  • Dizziness
  • Confusion
  • Nausea
  • Vomiting
  • Drowsiness or varying levels of alertness
  • Seizures
  • Loss of vision on one side
  • Enlarged pupil in one side of the body
  • Weakness on one part of the body
  • Shortness of breath or other changes in the breathing pattern

The individual might lose consciousness for a short span of time. This can be followed by a phase of alertness before falling into unconsciousness again. In some cases, the individual might even slip into a coma.

Management of an epidural hematoma

The treatment for an epidural hematoma is based on the seriousness of the condition and symptoms that might arise. Remember that other injuries or health conditions can also affect the treatment.

Surgical intervention

Generally, the doctor will suggest surgery to remove the hematoma, usually craniotomy. During the procedure, part of the skull is opened to remove the hematoma and lessen the pressure on the brain.


Before craniotomy or aspiration, drugs are given to lessen the inflammation and pressure. In most cases, hyperosmotic agents such as glycerol, mannitol and hypertonic saline are recommended which helps lessen the swelling in the brain.

After the removal, the doctor might prescribe anti-seizure medications to prevent seizures which are possible complications of head injuries.


The doctor might refer the individual to a physical therapist to help with the management of the symptoms and disabilities brought about by the injury.

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