Epidural hematoma: symptoms, causes and treatment

Definition

What is an epidural hematoma?

Epidural hematoma is a bleeding (hematoma) that occurs between the inside of the skull and the dura (the thick membrane covering the brain). This internal bleeding then causes brain swelling which causes the brain to experience a shift.

If the blood volume is very large, or the event is acute (sudden and immediate), this condition can cause increased pressure in the brain. High pressure in the brain has the risk of causing damage to brain tissue, as well as endangering lives if not treated quickly.

Epidural hematoma can cause brain tissue damage that can affect vision, speech, movement and body coordination, and awareness. If not treated immediately, epidural hematoma can cause general brain damage and even death.

Epidural brain hemorrhages are often the result of head injuries, whether from contact sports, motor accidents, or falls.

Signs and symptoms

What are the signs and symptoms of an epidural hematoma?

Symptoms of internal bleeding that cause an epidural hematoma usually appear minutes or hours after a head injury.

Some of the symptoms that can appear include:

• Confusion
• Dizzy
• The headache is so intense
• Drowsiness and decreased alertness
• Nausea or vomiting
• The pupil in one eye is enlarged
• Loss of consciousness, which can occur several times
• Feeling of weakness in the area opposite the side of the pupil of the dilated eye

You may pass out soon after the accident. But then you wake up and watch out for a few moments, before finally you fall back unconscious. You can even fall into a coma.

Cause

What are the causes of epidural hematoma?

Epidural bleeding is often the result of a fractured skull in children or adolescents. This is because the membranes covering the brain have not been completely attached to children, unlike the brains of adults. However, it is possible that this condition can also occur in adults.

The most common cause of bleeding in the brain is a severe injury to the head, such as a car or motorcycle accident, falls, physical violence (in the form of a hand, blunt force, or a direct kick to the head), or sports accidents.

There are several factors that cause epidural hematoma that can increase your risk of developing this condition, namely:

• do extreme physical activity, especially if you're not wearing a helmet
• has difficulty walking due to certain situations and conditions
• have experienced trauma or injury to the head
• taking anticoagulant drugs or blood thinners
• consuming alcohol
• do not fasten the seat belt when driving
• have blood clotting disorders, such as abnormalities in platelets

Diagnosis and treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What are the usual tests to diagnose this condition?

According to the MedlinePlus website, your doctor and medical team will likely perform a CT scan or MRI scan of your brain and nervous system. The test results will show if there are parts of your brain that are not working normally.

In addition, the test can also detect signs of increased pressure on the brain, such as headaches, vomiting, and mental confusion.

If there are any of these signs, the medical team may immediately take emergency action in the form of surgery to prevent further damage to the brain.

What are the treatment options for epidural hematoma?

Epidural hematoma treatment will depend on the severity and symptoms of your experience.

1. Operation

In most cases, epidural hematoma should be treated with a surgical procedure called a craniotomy. In this procedure, the surgeon will open the skull to drain the bleeding and reduce pressure on the brain.

2. Medicines

The doctor may also give you some preoperative medication for epidural hematoma problems that you are experiencing. These drugs aim to reduce swelling, such as mannitol, glycerol, and hypertonic salts.

After the hematoma surgery, you will also be given drugs that prevent seizures. You will likely be taking this drug for months, even years.

3. Postoperative recovery (physiotherapy)

An epidural hematoma can take a while to completely heal. The reason is, the treatment process itself can take 6 months to maybe two years after you experience the injury.

To speed up the healing process of a head injury, you are generally not allowed to do heavy work that can cause you to become tired. You are also advised to get plenty of rest and sleep and avoid alcohol.

If this brain hemorrhage causes you to experience disabilities or injuries such as weakness and difficulty walking, paralysis, loss of sense of taste, your doctor will refer you to a physiotherapist to help train your physical abilities.

Prevention

What are some lifestyle changes or can be done to prevent this condition?

Epidural hematoma is most often caused by traffic accidents. Therefore, the most important precaution is to ensure driving safety, such as:

• Obey regulations and traffic signs
• Use complete driving attributes, such as an SNI helmet of the appropriate size or a seat belt when driving by car
• Using security attributes in accordance with safety operational standards in the workplace

If you have any questions, consult your doctor for the best solution to your problem.