Epidural hematoma history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Patients with epidural hematoma may have a positive history of: Head trauma, spinal trauma, Bleeding disorders, blood vessel malformation and NS surgery. In traumatic cases of epidural hematoma, patients may develop signs and symptoms right after trauma, or weeks after that. Some patients with epidural hematoma may experience a lucid interval which is a period of time in which patient regains consciousness after a short period of unconsciousness. after lucid interval the sign and symptoms of epidural hematoma may get worse. The most common symptoms of epidural hematoma include: Severe headache, nausea and vomiting, dizziness, drowsiness or altered level of alertness, enlarged pupils, weakness and slurred speech. Less common symptoms of epidural hematoma include: seizures, unconsciousness and visual disturbance.

History and Symptoms

History

Patients with epidural hematoma may have a positive history of:

Common Symptoms

Less Common Symptoms

Less common symptoms of epidural hematoma include:[9][10][11]

References

  1. ↑ Mitsuyama T, Ide M, Kawamura H (2004). "Acute epidural hematoma caused by contrecoup head injury--case report". Neurol Med Chir (Tokyo). 44 (11): 584–6. PMID 15686177.
  2. ↑ Maugeri R, Anderson DG, Graziano F, Meccio F, Visocchi M, Iacopino DG (2015). "Conservative vs. Surgical Management of Post-Traumatic Epidural Hematoma: A Case and Review of Literature". Am J Case Rep. 16: 811–7. PMC 4652627. PMID 26567227.
  3. ↑ Foo D, Rossier AB (1982). "Post-traumatic spinal epidural hematoma". Neurosurgery. 11 (1 Pt 1): 25–32. PMID 7110563.
  4. ↑ Morsing IE, Brons P, Th Draaisma JM, van Lindert EJ, Erasmus CE (2009). "Hemophilia a and spinal epidural hematoma in children". Neuropediatrics. 40 (5): 245–8. doi:10.1055/s-0030-1248247. PMID 20221963.
  5. ↑ Paraskevopoulos D, Magras I, Polyzoidis K (2013). "Spontaneous spinal epidural hematoma secondary to extradural arteriovenous malformation in a child: a case-based update". Childs Nerv Syst. 29 (11): 1985–91. doi:10.1007/s00381-013-2214-5. PMID 23812629.
  6. ↑ Kim B, Moon SH, Kim SY, Kim HJ, Lee HM (2010). "Delayed Spinal Epidural Hematoma after En Block Spondylectomy for Vertebral Ewing's Sarcoma". Asian Spine J. 4 (2): 118–22. doi:10.4184/asj.2010.4.2.118. PMC 2996623. PMID 21165315.
  7. ↑ Radulovic D, Janosevic V, Djurovic B, Slavik E (2006). "Traumatic delayed epidural hematoma". Zentralbl Neurochir. 67 (2): 76–80. doi:10.1055/s-2006-933359. PMID 16673239.
  8. ↑ Mohsenipour I, Kostron H, Russegger L (1982). "[The lucid interval in epidural hematoma]". Zentralbl Neurochir. 43 (2): 121–8. PMID 7124188.
  9. ↑ 9.0 9.1 Scheibl A, Calderón EM, Borau MJ, Prieto RM, González PF, Galiana GG (2012). "Epidural hematoma". J Pediatr Surg. 47 (2): e19–21. doi:10.1016/j.jpedsurg.2011.10.078. PMID 22325415.
  10. ↑ 10.0 10.1 Kao FC, Tsai TT, Chen LH, Lai PL, Fu TS, Niu CC; et al. (2015). "Symptomatic epidural hematoma after lumbar decompression surgery". Eur Spine J. 24 (2): 348–57. doi:10.1007/s00586-014-3297-8. PMID 24760464.
  11. ↑ 11.0 11.1 Chen H, Guo Y, Chen SW, Wang G, Cao HL, Chen J; et al. (2012). "Progressive epidural hematoma in patients with head trauma: incidence, outcome, and risk factors". Emerg Med Int. 2012: 134905. doi:10.1155/2012/134905. PMC 3536037. PMID 23320175.

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Overview

History and symptoms

  • The most important symptoms of an extradural hemorrhage are:
  • Confusion
  • Dizziness
  • Drowsiness or altered level of alertness
  • Enlarged pupil in one eye
  • Headache (severe)
  • Head injury or trauma followed by loss of consciousness, an period of alertness, then rapid deterioration back to unconsciousness
  • Nausea and/or vomiting
  • Weakness of part of the body, usually on the opposite side from the side with the enlarged pupil
  • The symptoms usually occur within minutes to hours after a head injury and indicate an emergency situation.

As the hematoma expands, it strips the dura from the inside of the skull, causing an intense headache. Epidural bleeds can become large and raise intracranial pressure, causing the brain to shift, lose blood supply, or be crushed against the skull. Larger hematomas cause more damage. Epidural bleeds can quickly expand and compress the brain stem, causing unconsciousness, abnormal posturing, and abnormal pupil responses to light.[1] In the hallmark of epidural hematoma, patients may regain consciousness during what is called a lucid interval, only to descend suddenly and rapidly into unconsciousness later. The lucid interval, which depends on the extent of the injury, is a key to diagnosing epidural hemorrhage. If the patient is not treated with prompt surgical intervention, death is likely to follow.[2]

References

  1. ↑ Singh J and Stock A. 2006. "Head Trauma." Emedicine.com. Retrieved on February 6, 2007.
  2. ↑ Caroline NL. 1991. Emergency Medical Treatment. Little Brown & Company.

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