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Epidural Hematoma Updated 12/2010

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BASICS

  • Description
  • Etiology

DIAGNOSIS

  • Signs and Symptoms
  • Essential Workup
  • Tests
  • Differential Diagnosis

TREATMENT

  • Pre-hospital
  • Initial Stabilization
  • ED Treatment
  • Medication (Drugs)
  • In-patient Considerations
The following is an excerpt....
BASICS
Description
  • Direct skull trauma
  • Inward bending of cavarum causes bleeding when dura separates from skull:
    • Middle meningeal artery is involved in bleed >50% of time.
    • Meningeal vein is involved in 1/3.
    • Diploic venous sinus bleed is seen in <10%.
  • Skull fracture is associated in 75% of cases, less commonly in children.
  • >50% have epidural hematoma (EDH) as isolated head injury:
    • Most commonly associated with subdural hematoma (SDH) and cerebral contusion
  • Classic CT finding is lenticular, unilateral convexity, usually in temporal region.
  • It usually does not cross suture lines, but may cross midline.
Etiology
  • Accounts for 1.5% of traumatic brain injury (TBI)
  • Male/female incidence is 3:1.
  • Peak incidence is 2nd–3rd decade of life.
  • Motor vehicle accidents ...

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See Also
Images >
12
FIG. 10.23. Intracranial manifestations of head injury. A: Note the hypodense subdural hematoma (arrows). There is ipsilateral compression of the ventricles and contralateral midline shift. B: Epidural bleed (arrows) with some soft-tissue swelling of the scalp.Credit: From Swischuk LE. Emergency Imaging of the Acutely Ill or Injured Child 3rd, Edition. Philadelphia: Lippincott Williams & Wilkins, 1994.