If left untreated, an epidural hematoma can be life-threatening. It is important that a person who suffers a head injury knows of this possible complication and the signs to look for.
What is an epidural hematoma?
Epidural hematoma is bleeding around the brain that may occur after a head injury.
A blunt-force trauma to the head, potentially from a fall or car accident, may cause the brain to hit against the skull. When this occurs, a portion of the brain's cells, lining, or blood vessels can rupture.
The damaged cells can cause bleeding between the protective lining around the brain and the skull. This type of bleeding is called an epidural hematoma.
An epidural hematoma requires immediate medical attention. If left untreated, a person can lose consciousness, suffer long-term health consequences, or even die. It is important for a person who sustains a head injury to be aware of the symptoms of an epidural hematoma and to seek medical treatment immediately.
Symptoms of an epidural hematoma can develop rapidly after an injury or slowly over the course of several hours. The time it takes for symptoms to develop depends on the severity of the injury and how quickly blood is filling into the lining between the brain and skull.
Some of the most common signs and symptoms of an epidural hematoma include:
- loss of vision on one side
- changes in breathing
- severe headache
- weakness in one half of the body
- enlarged pupil in one eye
- drowsiness or loss of alertness
Before receiving treatment, a person may lose consciousness. It is also possible that a person may fall into a coma.
Certain sports have a high risk of head injuries, including contact sports such as boxing.
Epidural hematomas are the direct result of physical trauma to the head. Some of the most likely causes of an epidural hematoma include:
- head injury from a contact sport, such as football or rugby
- car accident
- fall from a ladder
- physical abuse or a violent attack
Some people have a higher risk than others of getting an epidural hematoma, including:
- people whose jobs involve fall risks
- older people
- those who regularly consume alcohol
- athletes in contact sports or sports with a fall risk, such as gymnastics
- those who cycle without wearing a helmet
- people taking blood-thinning medications
- people who do not wear a seatbelt in a vehicle
Treatment for an epidural hematoma will depend on the severity of the injury and the individual's overall health, as well as the presence of any other injuries or illnesses.
In many cases, a doctor will use one of two surgical procedures to remove the blood from the brain.
A craniotomy is more likely to be used for a severe hematoma. In this procedure, part of the skull is removed temporarily to remove the hematoma.
When the epidural hematoma is smaller or less severe, a doctor will likely recommend aspiration. Aspiration involves drilling a small hole in the skull. A doctor then uses suction to remove the hematoma.
Medication will likely be prescribed both before and after surgery. Prior to surgery, a person will require hyperosmotic agents to help reduce inflammation and swelling in the brain. These include mannitol, glycerol, and hypertonic saline.
After surgery, a doctor will likely prescribe anti-seizure medications, which may be taken for several months or even years following the injury.
Additionally, a doctor may prescribe or recommend pain medication or anti-inflammatory drugs to ease a person's recovery.
After treatment, recovery may take some time, depending on the severity of the epidural hematoma. Recovery will involve both home care and other therapies.
Gentle exercise should be increased gradually during the recovery period.
It is likely recovery from an epidural hematoma will take months or even years. In many cases, initial improvements happen within about 6 months after the injury.
There are several steps a person can take at home to aid recovery. Some recommendations include:
- increasing activity slowly
- getting plenty of rest
- avoiding future contact sports
- reducing or eliminating alcohol consumption
A doctor or therapist may also recommend an exercise routine. Exercise will help improve a person's strength and reduce feelings of weakness.
After treatment, a doctor will develop a rehabilitation plan that may include physical, occupational, and speech therapy.
Rehabilitative treatment aims to:
- improve strength
- regain bladder control
- improve gross motor skills, such as walking
- decrease paralysis and return sensation
- improve lost speech skills
An epidural hematoma is a potentially life-threatening complication of a head injury. If left untreated, a person can face serious consequences, including death. Even after prompt treatment, someone may have permanent brain damage or disability.
A person should seek immediate medical attention after a head injury to reduce the risks of long termcomplications. Following a doctor's recommendations after treatment can help ensure someone makes the best recovery possible.