The dura mater is usually bound quite firmly to the inside of the skull. Intracranial epidural hematoma occurs in approximately 2% of patients with head injuries and 515% of patients with fatal head injuries. Hemorrhages commonly result from accelerationdeceleration trauma and transverse forces. Edh can also occur secondary to the rupture of a vein, particularly if the middle meningeal vein or dural sinuses are involved. Epidural hematoma represents acute bleeding into the epidural space. Lesi ons lesions extraaxiales hematome hematome extradural hematome hematome extradural hematome sousdural tente sutures fracture fracture voute cranienne lesions lesions intraaxiales cest une urgence neurochirurgicale qui represente 2 a 3 % des lesions des traumatises craniens en imagerie. Other nonarterial sources of epidural hemorrhage include venous lakes, diploic veins, arachnoid granulations, and the petrosal sinuses. The personal experiences with a series of 57 conservatively treated extradural haematomas edh are presented and the criteria for conservative management outlined. Spontaneous intracranial extradural hematoma in sickle cell. Other symptoms may include headache, confusion, vomiting, and an inability to move parts of the body. Habituellement par choc indirect contre coup le plus souvent sans du crane.
Epidural hematoma, subacute epidural hematoma, posttraumatic epidural hematoma. Almost always venous due to tearing of subdural cortical bridging veins which extend to the dural sinuses. Disruption of the superior sagittal sinus may cause vertex edh. Epidural hematoma terjadi pada 1% trauma kepala, insiden tertinggi terjadi pada usia 2030 tahun, jarang terjadi pada usia dibawah 2 tahun atau lebih dari 60 tahun, disebabkan dura yang melekat erat pada tabula interna skull. Lhematome extradural lhematome extradural hed est une. Experience with 610 patients and prospective analysis. An extradural haematoma that occurs in the head is called an intracranial extradural. Common abbreviations and acronyms for hematome epidural. The classic epidural hematoma is observed with a linear skull fracture of the temporal bone, which tears the middle meningeal artery, allowing blood to accumulate under pressure in the epidural space. We report a 14 yearold boy who had tetraplegia on awakening. Head injury definition a history of a blow to the head or the presence of a scalp wound or those with evidence of altered consciousness after a relevant injury. Radiographic features distribution and appearance extradural hematoma. Extradural hematoma edhalso known as an epidural hematomais a collection of blood that forms between the inner surface of the skull and outer layer of the durawhich is called the endosteal layer.
Trauma to be brain can be associated with both epidural and subdural hematomas, among other injuries. Epidural and subdural hematomas intermountain healthcare. Patient evolved satisfactorily with a total recovery as much clinical as imaging. The circumferential arrangement of collagen surrounding the vein makes it susceptible to such tearing. Incidence of epidural hematoma, infection, and neurologic. Rarely, edh can occur secondary to arteriovenous abnormalities or other systemic bleeding disorders.
All structured data from the file and property namespaces is available under the creative commons cc0 license. Hematome sous dural dorsal compliquant une anesthesie. In general, surgical intervention for ish is indicated if the hematoma thickness exceeds 10 mm, there is a midline shift of greater than 5 mm, or there is neurologic deterioration. Hemorragia extradural pdf portuguese, hematoma intracraniano epidural, hematoma epidural, hematoma epidural intracraniano, hemorragia epidural, hematoma extradural. Epidural and subdural hematomas hematomas are bruises that are caused by injuries to blood vessels underneath the skin, known as a bruise. Epidural hemorrhage epidural hematoma, extradural hemorrhage, or hematoma. In the hallmark of epidural hematoma, people may regain consciousness and appear completely normal during what is called a lucid interval, only to descend suddenly and rapidly into unconsciousness later. Epidural hematoma an overview sciencedirect topics.
Tindakan operasi pada penyakit epidural hematoma l. Epidural hematomas may present with a lucid period immediately following the trauma and a delay before symptoms become evident. Since the introduction of ct, the frequency of this occurrence has gone up from 6% to 30%. The key difference between epidural and subdural stems from the type of bleeding that takes place during traumatic brain injury. Furthermore, some have advocated for the use of epidural blood patching in the treatment of ish caused by dural tears resulting in chronic csf leaks 22, 23. Classically due to injury of the middle meningeal artery, a branch of the maxillary artery from the eca. Subdural hematoma an overview sciencedirect topics. We report a clinical case of a 19yearold young man with sickle cell anemia who presented a sickle cell crisis. There are few reported cases of an epidural spinal hematoma following interventional pain procedures. Traitement conservateur des hematomes extraduraux chez l. If left untreated, a person can face serious consequences, including death. Epidural hematoma after routine epidural steroid injection. Nov 02, 2015 epidural haematoma extradural haemorrhage 1. Epidural haematoma extradural haemorrhage slideshare.
Acute subdural hematoma usually occurs after severe, highimpact injuries and is often associated with contusions of the adjacent areas of the brain. Epidural hematoma edh is a traumatic accumulation of blood between the inner table of the skull and the strippedoff dural membrane, which. If your institution subscribes to this resource, and you dont have a myaccess profile, please contact your librarys reference desk for information on how to gain access to this resource from offcampus. Main preconditions are absence of neurological deficit, close.
Surgical management of acute epidural hematomas request pdf. Spontaneous spinal epidural hematoma sseh is an uncommon cause of acute nontraumatic myelopathy. The syndrome of spontaneous spinal epidural hematoma in. A case history of an extradural haematoma of the posterior cerebral fossa is presented. Trauma or other injury to your head can cause your brain to bounce. Pdf epidural hematoma following spinal cord stimulator. Intracranial subdural hematoma after epidural anesthesia. Epidural blood patch is an iatrogenic epidural hematoma. Le diagnostic est pose le plus souvent par lechographie. When an injury happens to the head and brain, this trauma may be called epidural and subdural hematomas. If the subdural hematoma is small hematoma occurs when a mass of blood forms in the space between your skull and the protective covering of your brain. The posterior fossa is a rare location for traumatic injury, in general, including edh epidural hemorrhage epidural hematoma, extradural hemorrhage, or hematoma bleeding outside the outermost layer of the dural mater, which is thus stripped. Posttraumatic acute epidural hematoma edh is generally visible on the ct scan done immediately after admission.
If the inline pdf is not rendering correctly, you can download the pdf file here. Anterior temporal tip epidural hematomas have been postulated to form due disruption of the sphenoparietal sinus. Epidural hematomas are the direct result of physical trauma to the head. We report a case of a spinal epidural hematoma in a patient with no known risk factors e. Epidural bleeding occurs between the skull and dura. Incidence of epidural hematoma, infection, and neurologic injury in obstetric patients with epidural analgesiaanesthesia you will receive an email whenever this article is corrected, updated, or cited in the literature. Although surgery remains the treatment of choice for extradural hematomas edh, there were many cases reported in the literature with good outcome, even if they were not treated surgically. Paternitti s, falcone mf, fiore is the size of epidural hematomas related to outcome, acta neurochir wien 1998, 140, 953955. Epidural means outside the dura, and hematoma means mass of blood. The posterior fossa is a rare location for traumatic injury, in general, including edh epidural hemorrhage epidural hematoma, extradural hemorrhage, or hematoma bleeding outside the outermost layer of the dural mater, which is thus stripped away from the inner table of the. Surgical management of traumatic extra dural hematoma in children. Dec 07, 2017 an epidural hematoma is a potentially lifethreatening complication of a head injury. Pengobatan medikamentosa penyakkt epidural hematoma k. Four personal cases of spontaneous spinal epidurdl hemerrhage are reported.
Cerebrovascular diseases g45g46 and i60i69 after the epidural hematoma begins collecting, it starts to compress intracranial structures which may impinge on the cn iii. Epidural hematoma as seen on exgra scan with overlying skull fracture. An extradural haematoma that occurs in the spine is called a spinal extradural haematoma. However, venous epidural hematomas, caused by a dural sinus tear, are slower. Prise en charge medicochirurgicale a yaounde introduction l\hematome extra dural.
Some of the most likely causes of an epidural hematoma include. Hematoma epidural paling sering terjadi di daerah perietotemporal akibat robekan arteria meningea media. This lucid interval, which depends on the extent of the injury, is a key to diagnosing an epidural hematoma. Almost always arterial explaining the progressive growth of the hematoma. Epidural hematoma is when bleeding occurs between the tough outer membrane covering the. The most important findings were rapidly developing papilloedema, an ipsilateral hemiplegia, and the angiographic evidence of a pronounced hydrocephalus. The source of bleeding is usually arterial, most commonly from a torn middle meningeal artery. Epidural bleeding occurs between the skull and the dura mater, while subdural bleeding occurs between the dura mater and the arachnoid mater brain injury leads to a condition called hematoma. An epidural hematoma edh is bleeding between the inside of the skull and the outer covering of the brain called the dura. The extradural hematoma or epidural if the greek terminology is used is in its classic form a wellknown clinical entity taught in all medical schools. Tindakan pertolongan pertama pada epidural hematoma. Typically lentiform lensshaped, biconvex, lemonshaped and do not cross sutures as the periosteum crosses through the suture continuous with the outer periosteal layer. Based on the cases in the literature and on this individual observation, the authors refer to the importance of recognizing. The extradural hematoma or epidural if the greek terminology is used is in.
Hematome extradural du vertex par rupture du sinus longitudinal superieur. Tratamiento conservador del hematoma epidural agudo traumatico. In the cervical spine, patients can present with neurological deficits ranging from focal cervical radiculopathy to complete quadriplegia. Spontaneous extradural hematoma is rare in patients with sickle cell disease. Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Request pdf les hematomes extraduraux post traumatiques. Epidural blood patch ebp conventionally refers to the injection of autologous blood into the epidural space with the intent to seal off a dural tear and to stop cerebrospinal fluid csf leak. Epidural hematoma traumatic brain injury tbi causes. If the patient is not treated with prompt surgical intervention, death is likely to follow. Epidural hematoma ie, accumulation of blood in the potential space between dura and bone may be intracranial edh or spinal sedh see the image below. Experiences and analysis from 24 consecutively treated patients in a developing country. Extradural hematoma of the posterior fossa with concomitant. In the head, the epidural space is the potential space between the skull and the dura mater. Background extra dural hematoma edh is a major surgical emergency but its management in developing countries is still hindered by several difficulties related to infrastructure and financial.
They are usually associated with a history of head trauma and frequently associated skull fracture. Epidural hematoma trh11 3 skull xray may show associated skull fracture e. Acute subdural hematoma is usually caused by external trauma that creates tension in the wall of a bridging vein as it passes between the arachnoid and dural layers of the brains liningi. Epidural hematoma definition and patient education. Le premier cas a ete rapporte en 1977 par mc donald et coll. Epidural hematom dan subdural hematom subdural hematoma adalah perdarahan yang terjadi antara duramater dan araknoid, biasanya sering di daerah frontal, pariental dan temporal. May 31, 2019 emergency brain surgery was performed but kim died four days later.
An epidural hematoma occurs when a mass of blood forms in the space between your skull and the protective covering of your brain. Epidural hemorrhage epidural hematoma, extradural hemorrhage, or hematoma bleeding outside the outermost layer of the dural mater, which is thus stripped away from the inner table of the skull or spinal canal. Epidural hematoma following spinal cord stimulator implant article pdf available in international journal of emergency medicine 34. Difference between epidural and subdural compare the. Emergency brain surgery was performed but kim died four days later. Contact a health care provider for any head injury that results in even a brief loss of consciousness, or if there are any other symptoms after a head injury even without loss of consciousness the typical pattern of symptoms that indicate an edh is a loss of consciousness, followed by alertness, then loss of consciousness again. A right temporoparietal craniotomy was carried out to evacuation of the posterior hematoma. Penyulit tindakan bedah pada penyakit epidural hematoma n. Epidural hematoma is when bleeding occurs between the tough outer membrane covering the brain dura mater and the skull. The mechanisms responsible for the delayed appearance of the epidural hematoma. Hematome sousdural chronique et decompensation psychotique.
Often there is loss of consciousness following a head injury, a brief regaining of consciousness, and then loss of consciousness again. Lhematome extradural african journal of neurological. Extradural hematoma vs subdural hematoma radiology. First introduced over half a century ago as a treatment for intractable postural puncture headache pdph. Spinal epidural hematoma seh is a very rare cause of acute spinal cord compression and is estimated to occur in approximately 0. Files are available under licenses specified on their description page. The most important findings were rapidly developing papilloedema. Extradural hematoma edh, also known as an epidural hematoma, is a collection of blood that forms between the inner surface of the skull and outer layer of the dura, which is called the endosteal layer. If the subdural hematoma is small extradural hematoma is surgery always mandatory.
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