An epidural hematoma is a type of brain injury that occurs when blood accumulates between the skull and the outer layer of the brain (the dura mater). As a result, the brain tissue can become damaged. A head trauma, such as a fall, a car accident, or a sports injury, can cause an epidural hematoma. Also, it can result from a surgery or medical procedure involving the skull or brain.
The symptoms of an epidural hematoma may vary depending on the location and size of the bleeding, and the extent of the brain damage. Some common symptoms include:
Headache
Dizziness
Nausea and vomiting
Confusion
Drowsiness
Loss of consciousness
Seizures
Weakness or numbness on one side of the body
Difficulty speaking or understanding
Vision problems
Personality changes
There can be no symptoms at first, but they may develop later as the bleeding worsens. Therefore, it is important to seek medical attention as soon as possible after a head injury, even if the symptoms seem mild.
A doctor will conduct a physical examination and ask about the history of the head injury in order to diagnose an epidural hematoma. Some tests may be ordered to confirm the diagnosis and assess the severity of the condition.
In a computed tomography scan, X-rays are used to create detailed images of the brain and skull. CT scans show the location, size, and severity of the bleeding.
A magnetic resonance imaging (MRI) scan, which uses a powerful magnetic field and radio waves to create detailed images of the brain and the skull. In some cases, MRI scans may not be available or suitable, but they can reveal more details about brain tissue and blood vessels than CT scans.
In addition to measuring the blood's red blood cells, platelets, and clotting factors, blood tests can help determine the cause of the bleeding and the likelihood of complications.
Treatment options for epidural hematomas depend on the severity of the condition and the symptoms. The main goal of the treatment is to stop the bleeding, reduce the pressure inside the skull, and prevent further brain damage.
When epidural hematomas are small and stable and do not cause significant symptoms or brain compression, observation and monitoring may be sufficient. To ensure that the condition does not worsen, the doctor will regularly monitor the vital signs, the neurological status, and the imaging tests.
Symptoms may be relieved by painkillers, anti-nausea drugs, anti-seizure drugs, and steroids. The inflammation and swelling of brain tissue can also be reduced by medications, but they cannot reverse the damage or stop the bleeding.
For large or expanding epidural hematomas that cause severe symptoms or brain compression, surgery may be necessary. Surgery involves making a small hole or flap in the skull and removing the blood clot and the damaged tissue. In addition to relieving pressure inside the skull and restoring blood flow to the brain, surgery may also be necessary to repair the source of bleeding, such as a fractured skull or torn blood vessel.
The best way to prevent an epidural hematoma is to avoid head injuries. Some preventive measures include:
Wearing a helmet when riding a bike, a motorcycle, a skateboard, or a scooter, or when playing contact sports, such as football, hockey, or rugby.
Wearing a seat belt when driving or riding in a car, and using a child safety seat for children.
Avoiding falls by using handrails, removing tripping hazards, and wearing appropriate footwear.
Avoiding alcohol and drugs that can impair the judgment, the coordination, and the reaction time.
Seeking medical attention promptly after a head injury, even if the symptoms seem mild or absent.
