An epidural hematoma is a blood clot on the surface of the dura, the covering of the brain and spinal cord.
Trauma to the side of the head can fracture the thin bone there and tear the artery beneath causing an epidural hematoma. As the clot expands, it directs pressure on the adjacent temporal lobe which can lead to brain herniation, brain stem injury, and death.
Epidural hematomas are a neurosurgical emergency.
The patients are rapidly taken to the operating room for evacuation of the blood clot, control of the bleeding artery, and repair of the fracture.
Outcomes are highly correlated with pre-operative neurologic status. It is an example where prompt neurosurgical care can make a difference. If promptly treated, patients can make a full recovery. Without treatment, the risk for death and disability is very high.