How do you evacuate an epidural hematoma?

How do you evacuate an epidural hematoma?

In most cases, your doctor will recommend surgery to remove an epidural hematoma. It usually involves a craniotomy. In this procedure, your surgeon will open up part of your skull so they can remove the hematoma and reduce the pressure on your brain. In other cases, your doctor may recommend aspiration.

How is a spinal epidural hematoma treated?

Treatment. Treatment of a spinal subdural or epidural hematoma is immediate surgical drainage. Patients taking coumarin anticoagulants are given phytonadione (vitamin K1) 2.5 to 10 mg subcutaneously and fresh frozen plasma as needed to normalize the INR (international normalized ratio).

What causes spinal epidural hematoma?

Spinal epidural hematoma is a space-occupying lesion caused by several cause. It has been reported after trauma, lumbar puncture, epidural anesthesia, operation, coagulopathy, vascular malformation, neoplasm, hypertension, diabetes mellitus, pregnancy, anticoagulative medication, etc4,7,9,10,17,19,24).

Is a subdural or epidural hematoma worse?

In contrast, the bleeding that produces subdural hematomas is more free to spread in the looser space beneath the dura mater and typically runs from the front of the head to the rear. This makes subdural hematomas more deadly. Who gets epidural hematomas? They usually occur in people with significant blows to the head.

How do you know if you have an epidural hematoma?

Headache (severe) Head injury or trauma followed by loss of consciousness, a period of alertness, then rapid deterioration back to unconsciousness. Nausea or vomiting. Weakness in part of the body, usually on the opposite side from the side with the enlarged pupil.

What does crossing suture lines mean?

Cross suture lines since bleeding is below the dura, which is tightly attached to the calvarium, thus giving the “crescent shape” appearance on head CT. Can result in mass effect leading to uncal and/or tonsillar herniation if left untreated.

What are signs of epidural hematoma?

These include: pupils that are unequal (one is larger than the other), very high blood pressure, slow and extra-strong pulse, or the patient is unable to wake up. One very distinct sign of an epidural hematoma is colloquially named the “Talk and Die Syndrome.” It refers to what brain surgeons call transient lucidity.

How is an epidural hematoma diagnosed?

An epidural hematoma can be diagnosed using advanced imaging technologies. A computerized tomography (CT) scan produces a detailed picture of the brain using X-rays. This technology is commonly used to diagnose the location and size of the epidural hematoma. Another test that may be used is the magnetic resonance imaging (MRI) scan.

Does a hematoma get infected after surgery?

If severe hematomas are left unattended, death of tissue and infection can take place. In some cases, inappropriate care of the patient after surgery can lead to a hematoma, as well. The hematoma generally takes place just a few hours after surgery and can cause pain and staining.

Where would an epidural hematoma be located?

Epidural hematomas are most often located in the temporal region and often result from tearing of the middle meningeal vessels due to a temporal bone fracture. Venous epidural hematomas may occur as a result of a skull fracture or an associated venous sinus injury. These tend to be smaller and usually have a more benign course.