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Acute Epidural Hematoma: From Injury to Death Publisher



Rahimimovaghar V1 ; Bahmani H2 ; Hajiqasemi M3
Authors
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Authors Affiliations
  1. 1. Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
  3. 3. School of Medicine, Shahid-Beheshti University of Medical Sciences, Tehran, Iran

Source: Medical Journal of the Islamic Republic of Iran Published:2025


Abstract

Background: Acute epidural hematoma (AEDH) is a critical condition commonly resulting from trauma, particularly in young males aged 20 to 30 years. It arises from the accumulation of blood between the dura mater and the skull, leading to increased intracranial pressure (ICP) and various neurological symptoms. Early mechanisms, such as cerebrospinal fluid (CSF) shift and vasoconstriction, temporarily stabilize ICP, but as the hematoma grows, these compensatory processes fail. This failure results in a rapid progression of symptoms, including localized pain, nausea, vomiting, and, in severe cases, loss of consciousness or herniation. Results: Clinical presentations depend on the compression location, such as the “talk and die” phenomenon in posterior fossa AEDH or motor impairments due to subfalcine herniation. Advanced stages are marked by Cushing’s triad and posturing changes, indicating imminent herniation. Prompt recognition and intervention, typically surgical evacuation through craniotomy for indicated cases, are crucial for preventing mortality. Medical management focuses on controlling ICP through positioning and osmotic agents. Conclusion: Awareness of clinical symptoms and rapid treatment are vital for improving patient outcomes in this potentially fatal disorder. © Iran University of Medical Sciences