What is the pathophysiology of epidural hematoma?
An epidural hematoma (EDH) occurs when blood accumulates between the skull and the dura mater, the thick membrane covering the brain. They typically occur when a skull fracture tears an underlying blood vessel. EDHs are about half as common as a subdural hematomas and usually occur in young adults.
What causes epidural hematoma in spine?
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).
What is epidural haematoma?
An epidural hematoma (EDH) is bleeding between the inside of the skull and the outer covering of the brain (called the dura).
What is hematoma in pathology?
Hematoma is generally defined as a collection of blood outside of blood vessels. Most commonly, hematomas are caused by an injury to the wall of a blood vessel, prompting blood to seep out of the blood vessel into the surrounding tissues.
Can epidural hematoma cause midline shift?
Expanding high-volume EDH can produce a midline shift and subfalcine herniation of the brain. Compressed cerebral tissue can impinge on the third cranial nerve, resulting in ipsilateral pupillary dilation and contralateral hemiparesis or extensor motor response.
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.
Can an epidural cause an epidural hematoma?
Spinal epidural hematomas are most commonly spontaneous bleeds from veins caused by coagulopathies or over-thinning of your blood from anticoagulant medications. Other causes include: Fracture to the bones in your vertebrae. Lumbar puncture, epidural anesthesia.
What causes a spinal hemorrhage?
Spinal cord hemorrhage is most commonly caused by trauma, vascular malformations, or bleeding diatheses. Spinal cord hemorrhage usually presents as sudden, painful myelopathy, which may reflect the anatomic level of the hemorrhage.
What is the main source of bleeding in extradural epidural hematomas?
The source of bleeding is usually arterial, most commonly from a torn middle meningeal artery. EDHs are typically biconvex in shape and can cause a mass effect with herniation.
Is epidural hematoma venous or arterial?
Epidural hematomas are usually arterial in origin but result from venous bleeding in one third of patients. Occasionally, torn venous sinuses cause an epidural hematoma, particularly in the parietal-occipital region or the posterior fossa. These injuries tend to be smaller and associated with a more benign course.
What causes a hematoma?
A hematoma is the result of a traumatic injury to your skin or the tissues underneath your skin. When blood vessels under your skin are damaged and leak, the blood pools and results in a bruise. A hematoma forms as your blood clots, resulting in swelling and pain.
What are the characteristics of a hematoma?
Organized hematoma is characterized pathologically by a mixture of bleeding, dilated vessels, hemorrhage, fibrin exudation, fibrosis, hyalinization, and neovascularization. CT and MRI show heterogeneous findings reflecting a mixture of these pathological entities.
How is an epidural hematoma diagnosed?
Spontaneous spinal epidural hematomas are rare. Making the correct diagnosis often takes time and is difficult. Decompression surgery is at the forefront as a treatment option. However, conservative treatment can be performed in suitable patients.
What causes an epidural hematoma?
Epidural hematoma is a neurosurgical emergency
How does an epidural hematoma affect the body?
An epidural hematoma can put pressure on your brain and cause it to swell. As it swells, your brain may shift in your skull. Pressure on and damage to your brain’s tissues can affect your vision, speech, mobility, and consciousness. If left untreated, an epidural hematoma can cause lasting brain damage and even death.
What does epidural hematoma stand for?
Epidural hematomas are typically post-traumatic, resulting from direct blunt trauma to the skull. They are frequently associated with overlying skull fractures. They can occur in patients of any demographic but are more common in the young. They can compress the adjacent brain, causing midline shift and central downward brain herniation