Extradural Hematoma: Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Hema Swaroop Kurumella , Neurosurgeons

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Extradural hematoma is a serious condition where bleeding occurs between the skull and the outer layer of the brain called the dura mater. This can lead to an increase in pressure inside the skull, which can be harmful to the brain. The primary impact of extradural hematoma on health is the potential for neurological complications and even life-threatening consequences if not promptly addressed.

What are the Types of Extradural Hematoma?

Extradural hematoma is a type of traumatic brain injury that involves bleeding between the skull and the outer layer of the brain. There are several forms of extradural hematomas, each with its own characteristics and implications. Understanding the different types of extradural hematomas is crucial for proper diagnosis and treatment.

Acute Extradural Hematoma: A type of bleeding outside the brain but within the skull that develops rapidly after a head injury, often causing symptoms like headache, confusion, and loss of consciousness.
Subacute Extradural Hematoma: This type of hematoma occurs within a few days to a week after a head injury and may present with symptoms such as drowsiness, nausea, and weakness on one side of the body.
Chronic Extradural Hematoma: Characterized by a slower bleeding rate, this type of hematoma can develop over weeks to months after a head injury, leading to symptoms like recurrent headaches, seizures, and cognitive changes.
Traumatic Extradural Hematoma: Caused by a traumatic injury to the head, this type of hematoma typically results from skull fractures or other trauma that damages blood vessels, leading to bleeding between the skull and the dura mater.
Spontaneous Extradural Hematoma: Occurring without a history of head trauma, this rare type of hematoma is often associated with underlying conditions such as vascular abnormalities or blood clotting disorders and may present with sudden-onset severe headache, neurological deficits, or altered mental status.

What are the Symptoms of Extradural Hematoma?

An extradural hematoma typically presents with specific symptoms that are related to the accumulation of blood in the space between the skull and the outer layer of the brain. These symptoms can vary depending on the size and location of the hematoma but often include signs of increased intracranial pressure, neurological deficits, and changes in consciousness. Early recognition and prompt medical intervention are crucial to prevent potential complications associated with this condition.

Headache
Dizziness
Nausea and vomiting
Confusion
Drowsiness
Weakness in limbs
Visual disturbances
Seizures
Coma

What are the Causes of Extradural Hematoma?

Extradural hematoma is typically caused by head injuries that lead to bleeding between the skull and the protective covering of the brain. The main causes include trauma, such as a blow to the head, falls, or accidents. This condition can also occur due to skull fractures that damage blood vessels, resulting in the accumulation of blood outside the brain.

In some cases, the underlying cause may be medical conditions that affect blood clotting. Early recognition and prompt treatment are crucial in managing extradural hematomas to prevent potentially serious complications.

Head trauma
Skull fracture
Arterial bleeding
Venous bleeding

When to see a Doctor for Extradural Hematoma?

Extradural hematoma is a medical emergency in which blood collects between the skull and the outer covering of the brain, usually after a head injury. Prompt diagnosis and treatment are critical to relieve pressure on the brain and prevent permanent neurological damage or life-threatening complications.

If you or someone else experiences severe headache, loss of consciousness, confusion, repeated vomiting, seizures, weakness, or any neurological symptoms after a head injury, consult a Neurosurgeon immediately. Seek emergency medical care without delay, as rapid surgical intervention may be required to save life and preserve brain function.

Severe headache after a head injury.
Loss of consciousness or difficulty waking up.
Persistent confusion, drowsiness, or disorientation.
Repeated nausea or vomiting following head trauma.
Seizures after a head injury.
Weakness or numbness in the arms or legs.
Difficulty speaking, walking, or maintaining balance.
One pupil larger than the other or changes in vision.
Clear fluid or blood leaking from the nose or ears after trauma.
Any worsening neurological symptoms after a blow to the head.

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How is Extradural Hematoma Diagnosed?

Extradural hematoma is typically diagnosed through a combination of medical history assessment, physical examination, and imaging tests. Healthcare providers will review the patient's symptoms, such as headache, confusion, or loss of consciousness, and inquire about any recent head trauma.

During the physical exam, they may check for signs of brain injury. Imaging tests like CT scans or MRI scans are crucial in confirming the presence of an extradural hematoma by providing detailed images of the brain and skull. These diagnostic tools help healthcare professionals determine the size and location of the hematoma, guiding appropriate treatment decisions.

Cranial CT scan
MRI scan
Neurological examination
Glasgow Coma Scale assessment
Skull X-ray

What are the Treatments for Extradural Hematoma?

Extradural hematoma is a serious condition that requires prompt treatment. The main treatment options include surgical intervention to remove the blood clot that is putting pressure on the brain. This procedure helps relieve the pressure and prevent further damage to the brain. In some cases, medication may also be used to manage symptoms such as pain and swelling. It is important to seek medical attention immediately if you suspect you or someone else may have an extradural hematoma.

Surgical Evacuation: A surgical procedure to remove the hematoma and relieve pressure on the brain.
Observation and Monitoring: Close monitoring in the hospital to watch for any signs of neurological deterioration.
Medication: Pain management and prevention of seizures with appropriate medications.
Physical Therapy: Rehabilitation to help regain strength, coordination, and mobility after treatment.
Follow-up Care: Regular follow-up appointments to monitor recovery progress and address any potential complications.

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What are the Risk Factors for Extradural Hematoma?

Extradural hematoma is a serious condition characterized by bleeding between the skull and the outermost covering of the brain. Several factors can increase the risk of developing this condition. These risk factors are related to activities or conditions that may lead to head injuries, which can trigger the formation of an extradural hematoma. Understanding these risk factors is crucial in preventing and managing this potentially life-threatening condition.