An epidural hematoma is a collection of blood or a blood clot between the skull and the dura, the lining of the brain. It is usually caused by trauma that disrupts the blood vessels outside of the brain. It accounts for 1% of all head trauma and occurs 4 times more in males than in females. It most typically occurs in young adults.

Signs and symptoms can include loss of consciousness, history of trauma, a unilateral paralysis or numbness, unilateral pupil dilation, headache, nausea, vomiting, seizures, slow heart beat, confusion, and even coma. These all depend on the pressure the blood clot places on the brain as well as the amount of brain injury of any.

Epidural hematomas are most often diagnosed by CT scan of the head.  A little less than half occur without associated skull fracture.

Treatment is depends on the size and timing of the hemorrhage.  In cases of very small hematomas with no pressure on the brain, they may be followed on repeat CTscans.  However, in the case of significant hematomas or in a patient with a deteriorating neurological exam, they may require surgical removal by a neurosurgeon.

Lindsey Parker PA-C and Justin F. Fraser M.D.