Epidural Hematoma

Prepared by: Korina Marie D. Flores

A slip and fall is all it takes to puncture an artery and cause an...

Brain• Most Complex

part of the body.• Center for every

feeling, impulse & regulation of body organs.

Skull• Tough covering to

protect it from damage and, ultimately, epidural hematoma.

• Protects the brain from damage, and just inside the skull is a leathery outer surface called the dura that attaches directly to the brain.

Dura Mater

• Brain shifts inside the skull

The shift can cause tiny tears in nearby arteries…

Middle meningeal artery

• The artery that runs between the dura and the skull inferior to a thin portion of temporal bone.

Hemorrhage from this artery causes rapid pressure on the brain.

…and the result is bleeding inside the brain cavity.

• The epidural hematoma that builds inside the brain leaves no room for the brain, so it begins to shift and push against the brain stem. It affects speech, movement, breathing, and even results in the loss of consciousness.

Brain Stem connects spinal cord to the remaider of the brain.

Medulla Oblongataregulation of heart rate and blood vessel diameter, breathing, swallowing, vomiting, coughing, sneezing, balance, and coordination

Pyramids extend the length of the Medulla. Consists of descending nerve tracts, which transmit action potentials from the brain to motor neurons of the spinal cord and are involved in the conscious control of skeletal muscles.

Pons• Breathing, swallowing, balance, chewing and salivation.

Midbrain• Visual reflexes: eye movement, pupil diameter, lens shape auditory

nerve pathways, general body movement regulation.

Reticular Formation• Group of nuclei that plays an

important function in the brain• Respiration, walking, chewing• Arousing and maintaining

consciousness• Sleep and wake cycle

Symptoms are caused by the expanding hematoma

CT Scan results of Epidural Hematoma

Momentary loss of consciousness at the time of injury, followed by an interval of apparent recovery (lucid interval)

• During the lucid interval, compensation for the expanding hematoma takes place by rapid absorption of CSF and decreased intravascular volume, both of which help maintain a normal ICP. When these mechanisms can no longer compensate, even a small increase in the volume of the blood clot produces a marked elevation in ICP.

• An epidural hematoma is considered an extreme emergency, marked neurologic deficit or even respiratory arrest can occur within minutes.

Treatment consists of making openings through the skull (burr holes) to decrease ICP emergently, remove the clot, and control the bleeding. A craniotomy may be required to remove the clot and control the bleeding. A drain is usually inserted after creation of burr holes or a craniotomy to prevent reaccumulation of blood.