Last updated:10-31-2009
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Definition and causes of Epidural hematoma - Epidural bleeding

Epidural hematoma or bleeding is located between the hard brain membrane meninges and the skull.
Such bleeding occurs after a sharp blow to the head, in connection with fracture of the skull and stems from the rupture of an artery between the brain membrane and the skull with blood leaking into the cavity.
In contrast to bleeding under the hard brain membrane, this results in symptoms rather quickly. This is because the brain is stuck onto the skull in several places with the blood having very limited space to spread. The pressure therefore rises fast and it is the compression of the brain tissue which causes the symptoms.

Symptoms of epidural bleeding

The symptoms occur in most cases within 24 hours after the injury. However, it is not unusual that the patient is alright for the first couple of hours after the accident only then to feel the symptoms which are: 
  • Sudden onset of severe headache.
  • Nausea and vomiting.
  • Confusion, drowsiness, possibly. unconsciousness.
  • Pupil difference (one larger than the other). 
It is a serious condition which must not be ignored and the patient might go into a gradual deterioration in some cases ending with coma and death. 

Precautions and treatment of a epidural bleeding

Blows to the head are very common, but epidural bleeding is quite rare. Usually, there is no reason for concern, especially if, after the blow, there are no symptoms. On the other hand, any of these symptoms, which can also be signs of a concussion demand medical attention, for example taking the patient to the nearest emergency room. 
To determine if there is bleeding requires a CT scan (see: image of the brain). In order to drain the bleeding a small burr hole is made which almost immediately relieve the symptoms with good recovery prospects. If the bleeding is comprehensive or old there may be permanent impairment.

Related articles:

Bleeding between the hard skull and the meninges (Epidural bleeding / Epidural hematoma)
Bleeding in the middle meninges (Subaraknoidea bleeding)
Bleeding under the hard meninges (Subdural bleeding / Subduralt hematoma)
Stroke - including blood clot and haemorrhage in the brain
TCI (Transitional cerebral ischemia)



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