Epidural Hematoma: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Epidural Hematoma?
A neurosurgeon (a surgeon who operates on the brain and spine) treats an epidural hematoma. An emergency medicine doctor (a doctor who treats sudden, serious problems) usually sees you first. It is an emergency, so care starts in the emergency room. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is an epidural hematoma?
An epidural hematoma (EDH) is bleeding between the inside of the skull and the outer covering of the brain. That covering is called the dura mater.
Fast bleeding forms a collection of blood, called a hematoma. It presses on the brain. The pressure inside the head, called intracranial pressure, rises quickly. This pressure may cause more brain injury. Epidural hematomas can happen within minutes to hours after injury. They are particularly dangerous.
Symptoms
The most important symptoms of an EDH are:
- Confusion.
- Dizziness.
- Drowsiness or a change in how alert you are.
- An enlarged pupil in one eye.
- A severe headache.
- Nausea or vomiting.
- Weakness in part of the body, usually on the opposite side from the enlarged pupil.
- Seizures from the head impact.
The typical pattern is a loss of consciousness after a head injury. Then the person is alert for a time. Then the person quickly passes out again. This pattern may not appear in everyone.
Symptoms usually occur within minutes to hours after a head injury and point to an emergency. Sometimes bleeding does not start for hours after the injury. Signs of pressure on the brain may not occur right away.
Causes and who gets it
An EDH is often caused by a skull fracture (a broken skull bone) during childhood or adolescence. This type of bleeding is more common in young people. It can also happen when a blood vessel, usually an artery, bursts and bleeds into the space between the dura and the skull.
Skull fractures often tear these vessels. Most fractures come from a severe head injury, such as a motorcycle, bicycle, skateboard, snowboarding, or car accident. A less severe blow, such as being hit by a baseball, can also cause an EDH.
How doctors diagnose it
The doctor does a brain and nervous system (neurological) exam. It may show that part of the brain is not working well, such as weakness in one arm.
A head CT scan without contrast dye confirms the diagnosis. It also shows the exact spot of the hematoma and any skull fracture. An MRI may help find small epidural hematomas.
Treatment
An EDH is an emergency. Treatment goals are to save the person's life, control symptoms, and prevent or limit permanent brain damage. Life support may be needed.
Emergency surgery is often needed to lower pressure in the brain. A surgeon may drill a small hole in the skull. This lets blood drain outside the skull. Large hematomas or solid clots may need to be removed through a larger opening in the skull, called a craniotomy.
Other medicines depend on the symptoms and the brain damage. Antiseizure medicines may be used to control or prevent seizures. Some medicines can reduce brain swelling. People on blood thinners or with bleeding disorders may need treatment to prevent more bleeding.
An EDH has a high risk of death without prompt surgery. Even with prompt care, a significant risk of death and disability remains. Brain injury can be permanent even when treatment is quick. Seizures may last for several months after treatment and may start up to 2 years after the injury. If there is brain damage, full recovery is not likely.
When to see a doctor
Call 911 or go to the emergency room if symptoms of an EDH occur after a head injury. These include a loss of consciousness, a period of alertness and then fast worsening, a severe headache, vomiting, confusion, drowsiness, a seizure, weakness in part of the body, or an enlarged pupil in one eye. Trouble breathing after a head injury or after treatment also needs 911. Contact your health care provider if there are other, milder symptoms after a head injury.
Spinal injuries often occur with head injuries. If you must move the person before help arrives, keep the neck and spine still.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Because an EDH is an emergency, care starts at the emergency room. Afterward, such a doctor can help with follow-up visits and coordinate your specialists.
Common questions
Is an epidural hematoma an emergency?
Yes, an epidural hematoma is an emergency. Call 911 or go to the emergency room if symptoms of an EDH occur.
Can a person seem fine after a head injury and still have an epidural hematoma?
Yes, it can happen. Sometimes bleeding does not start for hours after the injury. Signs of pressure on the brain may not occur right away.
Can an epidural hematoma be prevented?
Not always. An EDH may not be preventable once a head injury has occurred. Safety gear such as helmets and seat belts lessens the risk of head injury.
Do people fully recover from an epidural hematoma?
Not always. If there is brain damage, full recovery is not likely. In adults, most recovery occurs in the first 6 months, and there is usually some improvement over 2 years.
Sources
- MedlinePlus - Epidural hematoma
- National Institute of Neurological Disorders and Stroke - Traumatic Brain Injury (TBI)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
