Epidural hematoma is a condition when blood enters and accumulates in the space between the skull bones and the outer covering of the brain. This condition can cause visual disturbances, awareness, and the ability to move and speak. The brain and spinal cord are protected by membranes called the meninges. In order from outermost to innermost, the meninges are divided into the dura, arachnoid, and pia membranes.
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| Epidural Hematoma, Causes, Diagnosis, Treatment, Prevention, Complications |
In an epidural hematoma or epidural bleeding, blood enters and accumulates in the space between the skull and the dura. This condition can increase pressure in the head and potentially put pressure on the brain. If not treated immediately, an epidural hematoma can cause brain damage, even death.
Causes of Epidural Hematomas
Epidural hematomas are usually caused by head injuries that cause fractures or cracks in the skull, damage or tears to the lining of the dura, and damage to blood vessels in the brain. Head injuries themselves can occur due to impact, blow, explosion, or due to an accident.
Apart from head injuries, epidural hematomas can also be caused by the following conditions:
- Paget's disease of the skull
- Infection or abscess
- Tumor
- Abnormalities of the blood vessels, so they break easily
Risk factors for epidural hematoma
There are several factors that can increase a person's risk of experiencing an epidural hematoma, namely:
- Experiencing conditions that can increase your risk of falling, such as old age, difficulty walking, having had a stroke, or consuming alcoholic beverages excessively
- Taking blood thinners, such as warfarin
- Have had a head injury
- Not using personal protective equipment when engaging in activities with a high risk of injury, such as driving, playing sports or doing construction work
It's important to remember, children under 2 years of age are at high risk of developing an epidural hematoma if their head is hit or shaken. This is because the lining of the brain and skull are still fragile.
Epidural Hematoma Symptoms
Symptoms of an epidural hematoma generally appear minutes or hours after the injury occurs. Symptoms depend on the severity of the patient's condition, but generally include:
- Headache
- Nausea and vomiting
- seizures
- Impaired vision in one or both eyes
- Impaired communication (aphasia)
- Weakness or numbness in the limbs
Some people with epidural hematoma also experience a pattern of symptoms. These symptoms begin with a decrease in consciousness, then awareness, then return to loss of consciousness.
When to see a doctor
Epidural hematoma is an emergency. Therefore, immediately seek help to the emergency room at the nearest hospital if someone experiences symptoms of an epidural hematoma. Treatment must be given quickly, especially if the person loses consciousness after experiencing an impact to the head.
Diagnosis of Epidural Hematoma
The doctor will ask questions and answers about the symptoms experienced, history of collision, and the patient's health condition. Next, the doctor will carry out a thorough physical examination.
After that, to establish a diagnosis, the doctor will carry out further examinations in the form of:
- Neurological tests, to find out how well the brain and spinal cord are working
- CT scan, to observe and see the condition of the skull and brain bones
- Electroencephalography (EEG), to observe electrical activity in the brain
Epidural Hematoma Treatment
Treatment for an epidural hematoma aims to relieve symptoms and prevent permanent damage to the brain. The doctor will adjust the treatment according to the severity of the condition, the symptoms that appear, and the patient's health condition.
Several methods that can be used to treat epidural hematomas are:
Operation
Surgery is the first method of treatment performed to treat epidural hematomas. The aim of the operation is to relieve pressure on the brain and drain blood that has accumulated in the space between the skull and dura.
Apart from that, the doctor may also do a craniotomy. This operation is performed by opening the skull bone, to remove blood clots that have accumulated. That way, the pressure inside the head is reduced.
Drug
Doctors can give mannitol infusions to reduce pressure in the head due to blood buildup. In addition, doctors can also provide anti-seizure drugs to relieve or prevent seizures.
Rehabilitation
The doctor will advise the patient to consult a medical rehabilitation doctor and undergo physiotherapy (physical therapy). Physiotherapy aims to train the functions of limbs that are lost and arising from injuries, such as difficulty walking, paralysis, numbness, and being unable to hold back urination or defecation.
Self-care at home
In addition to the treatment methods above, patients can also make independent efforts at home to help the recovery process, such as:
- Follow the doctor's recommendations for physical exercise at home
- Increase physical activity gradually
- Avoid consuming alcoholic beverages
- Avoid sports with heavy intensity
- Get enough rest
Complications of Epidural Hematoma
If not treated quickly, people with epidural hematomas are at risk of permanent brain injury.
Permanent brain injury caused by an epidural hematoma can cause long-term disorders, such as epilepsy characterized by seizures, paralysis, or other neurological disorders.
In addition, epidural hematomas can also cause complications in the form of:
- Brain herniation
- Hydrocephalus, which is the buildup of fluid in the cavity of the brain which can put pressure on the brain
- Death
Epidural Hematoma Prevention
Epidural hematoma can be prevented by avoiding the risk of head injury. Some efforts that can be done are:
- Use personal protective equipment when driving, playing sports or working in building construction
- Avoid consuming alcoholic beverages, especially when driving
- Be careful in your activities and clean the area where you live or work from objects that you can trip over or slip on
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