Epidural hematoma

Epidural hematoma

    * Introduction
    * Signs and symptoms
    * Diagnosis
    * Treatment
Epidural hematoma is a type of brain damage that occurs trauamtica an accumulation of blood between the dura (thick membrane of central nervous system) and the skull. Dura mater covers the spinal cord and epidural blood so it can accumulate in the spinal column. Often due to trauma is a potentially deadly condition because the accumulation of blood pressure may increase intracranial space and compress delicate brain tissue.
The condition is present in 1-3% of cases of head injuries. Between 15-20% of patients with epidural hematomas die. Epidural bleeding, subdural or subarahnoid as those are extra-axial and appear outside the brain tissue while comprising axial hemorrhage and intraventricular hemorrhage intraparenchimatoase appear inside it.
Epidural bleeding is rapid because it occurs in arteries that are high pressure vessels. Epidural hemorrhage in the arteries can grow up to reach maximum size in 6-8 hours, accumulated from 25-75 cc of blood in the intracranial space. As the hematoma expands forcing skull removed dura intense headache. Bleeding may become large and growing epidural hemorrhage, causing brain displacement, loss of blood intake or crushing the skull. Large hematoma cause more severe injuries. Epidural bleeding can expand rapidly and compress the brain stem causing unconsciousness, abnormal position and RASP [anointed abnormal pupil to light.
On CT and MRI scanning epidural hematoma usually appears convex as expansionarea to stop the skull sutures where the dura is tightly attached to the skull. Epidural hematoma appearance of the lens brings lentiforme name. Epidural hematomas can occur in combination with subdural or single. CT scan showed subdural hematoma or epidural at about 20% of unconscious patients. Patients know they can win is called lucid interval only to relapse later unconscious quickly. Lucid interval which depends on the extent of lesion is the key to the diagnosis of epidural hemorrhage. If not treated promptly to Member States surgical patient will die.
Main cause is usually Traumatic Epidural hematoma although Spontaneous hemorrhage could occur. Bleeding arising from acceleration-deceleration trauma and transverse forces. 10% of venous bleeding may be due to rotational or linear forces caused when tissues of different densities or slide one another. Epidural hematoma resulting in a strike on one side of ticks. Region pterion meninges covering the artery is relatively poor and middle-prone lesions. Therefore, only 20-30% of epidural hematomas occur outside the temporal bone. The brain can be damaged by protruding inside the skull. Epidural hematoma is usually discovered by the same part of the brain that has been impacted by the strike, but in rare cases may be due to contralateral injury.
As in other types of intracranial hematoma can be removed surgically blood to remove the mass and reduce pressure on the brain. Neurochirrgical hematoma is evacuated through a burr hole or craniotomy. The prognosis is good if there was a lucid interval Dacite if the patient was comatose at the time of injury. Unlike other forms of intracranial hematoma in these patients with Glasgow score of 3 if they receive a good evolution promise immediate surgery.
Pathogenesis and causes: Cranial epidural hematoma: Epidural hematoma, or blood accumulating in the space between dura and bone can be intracranial or spinal. Intracranial form occurs in approximately 2% of patients with head injury and 5-15% in patients with fatal head injuries. It is considered to be the most severe complication of head injuries requiring immediate diagnosis and surgery. It can be acute, subacute or chronic. Usually result from contact with a force strong linear ordeal that causes separation of bone and dura periostiale interruption due to mechanical stress interposed vessels. Skull fractures occur in 95% of all adults, but children are far less plasticity daotorita immature calvaria. Sructurile arterial or venous compromise can be compressed and causing rapid accumulation of the hematoma, however, chronic or delayed manifestations may occur when venous sources are involved. Extension of the hematoma is usually limited by the sutures of the skull with dura attachment gathered in this place. Recent analysis showed that hematoemele epidural shots can cross in a minority of cases.
Region temporoparietala meningeal artery and the average are most often involved anterior ethmoid artery, although the lesions may be implciata frontae, transverse or sigmoid sinus in the occipital and superior sagittal sinus trauma vertex. Bilateral epidural hematoma include 2-10% of all acute hematoma in adults but are rare in children. Epidural hematoma of posterior fossa represent 5% of cases of epidural hematoma. Spinal epidural hematoma: Spontaneous spinal epidural hematoma may be small or after a trauma such as lumbar puncture or epidural anesthesia. May be associated with anticoagulation, thrombosis, blood dyscrasia, coagulopathy, thrombocytopenia, neoplasms or vascular malformations. Epidural venous plexus is usually involved, although arterial sources of bleeding may occur. Dorsal aspect of thoracic or lumbar region is involved most often with limited expansion to several vertebral levels. Bleeding in the epidural space of the spine can also cause epidural hematoma. It can occur spontaneously during birth or as a rare complication of epidural anesthesia or surgery in laminectomy. Anatomy of epidural space induces a hematoma Altfeld's profile from the skull. The column contains fatty tissue and epidural space epidural venous plexus, a network of thin-walled veins. This is probably venous bleeding. Anatomical abnormalities and blood dyscrasia these injuries are likely. They may cause pressure on the spinal cord or ponytail syndrome pain, muscle weakness or bladder or bowel dysfunction.