Epidural Hematoma (EPH)
Epidural Hematoma (EPH): Overview, Symptoms, and Treatment
What is Epidural Hematoma?
Epidural hematoma (EPH) is a collection of blood that forms between the outer membrane covering the brain or spinal cord (the dura mater) and the surrounding bone. When it occurs in the spinal canal, it is termed spinal epidural hematoma. This condition can lead to compression of the spinal cord or brain, which is a medical emergency requiring urgent intervention.
Symptoms of Epidural Hematoma
Symptoms typically begin suddenly and may include:
- Severe localized back or neck pain, often radiating along affected nerve roots (spinal cases).
- Neurological deficits such as weakness, numbness, or paralysis below the level of the hematoma.
- Radicular pain or sensory disturbances depending on the hematoma location.
- Loss of bladder or bowel control in severe cases involving spinal cord compression.
- In cranial epidural hematomas, symptoms include headache, confusion, vomiting, and loss of consciousness.
Causes and Risk Factors
EPH can result from:
- Traumatic injury or fractures affecting the skull or vertebrae.
- Spinal procedures such as lumbar puncture or epidural anesthesia.
- Blood clotting disorders and anticoagulant therapy increasing bleeding risk.
- Vascular abnormalities or tumors.
Diagnosis
MRI is the preferred imaging modality to identify spinal epidural hematomas and assess the extent of spinal cord or nerve root compression. CT myelography may be used if MRI is unavailable.
Treatment
EPH is a neurosurgical emergency requiring prompt intervention:
- Surgical decompression through laminectomy or laminotomy to evacuate the hematoma and relieve pressure.
- Supportive care including stabilization, pain management, and rehabilitation.
- Early surgery improves neurological outcomes and reduces permanent deficits.
Key Points
- Epidural hematoma is bleeding between dura mater and bone, causing neural compression.
- Symptoms include sudden pain and neurological deficits; spinal cases often present with back pain and radiculopathy.
- Causes include trauma, spinal procedures, coagulation issues, and vascular lesions.
- Diagnosis is primarily by MRI.
- Immediate surgical decompression is critical for optimal recovery.
Consult with Our Team of Experts Now!
If you have sudden severe back or neck pain with neurological symptoms, seek emergency care immediately. Our specialized team provides rapid diagnosis and supportive treatments including Cellular Therapy and Stem Cells for epidural hematoma to preserve neurological function.
References:
Vastani A, Mottaghi K, Rasouli MR. Prognostic factors and surgical outcomes of spontaneous spinal epidural hematoma: a systematic review and meta-analysis. Neurosurg Rev. 2022 Dec;46(1):21. doi:10.1007/s10143-022-01914-0. Available at: https://pubmed.ncbi.nlm.nih.gov/36538111/
