What is an Epidural Hematoma?

An epidural hematoma is a very serious condition that can happen after a hard blow to the head. If not immediately diagnosed and treated, it can be fatal. Epidural hematomas occur in 2 percent of all head injuries, and account for 5 to 15 percent of all fatal head injuries a year.

The brain is held in place by a series of connective tissues. When the head receives any type of hard hit, the brain may hit the skull, causing tearing in the connective tissues, bruising, and, in severe cases, bleeding. If the bleeding takes place outside of the thick covering protecting the brain, an epidural hematoma can occur. Skull fractures are another common cause of epidural hematomas, especially when the fracture causes bleeding in the brain.

The most common sign of an epidural hematoma is a short loss of consciousness, followed by up to several hours of awareness. Eventually, brain function will deteriorate, possibly leaving the patient in a coma. Other symptoms include bruising beneath the eyes and behind the ears, nausea, high blood pressure, vomiting, and seizures. If the hematoma goes untreated, it can lead to brain damage or even death.

The diagnosis of an epidural hematoma is usually done through a computed tomography (CAT) scan. Technicians will check for a large dark mass against the skull that appears to be pushing against the brain. Small hematomas will heal on their own and do not require treatment. The patient will be monitored for a few days, and then released. More serious hematomas, the ones that can lead to brain damage or death, are treated through surgery. During the surgery, the clot will be removed, and any cuts or tears will be repaired to prevent the hematoma from reoccurring.

Although the recovery of a patient after any type of brain injury can vary widely, about 90 percent of all epidural hematoma patients make full recoveries. Patients who fall into a coma have a much smaller chance of favorable outcomes, however, with only 40 to70 percent of patients surviving. Lack of pupil response is another indicator of a likely negative outcome.

Medical treatment should be sought after any serious head injury. Even though epidural hematomas are rare, they can present a very serious health risk if they are not immediately diagnosed. The sooner an injury is treated, the smaller the likelihood of a serious epidural hematoma going unnoticed, causing serious brain damage or fatality.