
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions β written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Epidural hematoma natural history, complications and prognosis
Introduction
Overview
Overview
If left untreated, patients with epidural hematoma may progress to develop permanent paraplegia, loss of sensation, brain herniation, coma and death. Common complications of epidural hematoma include: brain herniation, death, post-traumatic seizures, visual problems, persistent paraplegia, Coma, loss of sensation, priapism, disturbed circulation of the cerebrospinal fluid and Urinary retention. Prognosis is generally good in patients treated surgically without delay. In patients with acute epidural hematoma the surgery in an interval under two hours leads to 17% mortality rate and 67% of good recoveries but in patients who recover after an interval of more than two hours the mortality rate is 65% and good recovery rate is 13%. Overall mortality rate of patients with epidural hematoma is approximately 25%. The percentages of overall good recoveries and minimal neurologic deficit in patients with epidural hematoma is approximately 58%. The prognosis is worse in older patients and in patients with concomitant injuries of other body regions.
Natural History, Complications, and Prognosis
Natural History, Complications, and Prognosis
Natural History
- If left untreated, patients with epidural hematoma may progress to develop permanent paraplegia, loss of sensation, brain herniation, coma and death.[1][2][3][4][5]
Complications
- Common complications of epidural hematoma include:
- Brain herniation[4]
- Death[6]
- Post-traumatic seizures[7]
- Infarction of the brain tissue which may cause:
- Disturbed circulation of the cerebrospinal fluid[9]
- Urinary retention[10]
Prognosis
- Prognosis is generally good in patients treated surgically without delay.[11]
- In patients with acute epidural hematoma the surgery in an interval under two hours leads to 17% mortality rate and 67% of good recoveries but in patients who recover after an interval of more than two hours the mortality rate is 65% and good recovery rate is 13%.[12]
- Overall mortality rate of patients with epidural hematoma is approximately 25%.[12]
- The percentages of overall good recoveries and minimal neurologic deficit in patients with epidural hematoma is approximately 58%.[12]
- The prognosis is worse in older patients and in patients with concomitant injuries of other body regions.[12]
References
References
- β 1.0 1.1 1.2 Cuenca PJ, Tulley EB, Devita D, Stone A (2004). “Delayed traumatic spinal epidural hematoma with spontaneous resolution of symptoms”. J Emerg Med. 27 (1): 37β41. doi:10.1016/j.jemermed.2004.02.008. PMIDΒ 15219302.
- β 2.0 2.1 Anipindi S, Ibrahim N (2017). “Epidural Haematoma Causing Paraplegia in a Patient with Ankylosing Spondylitis: A Case Report”. Anesth Pain Med. 7 (2): e43873. doi:10.5812/aapm.43873. PMCΒ 5559664. PMIDΒ 28824860.
- β 3.0 3.1 Gogarten W, Hoffmann K, Van Aken H (2010). “[Recommendations for the administration of conventional and new antithrombotic agents from the perspective of anesthesiology]”. Unfallchirurg. 113 (11): 908β14. doi:10.1007/s00113-010-1881-x. PMIDΒ 21069508.
- β 4.0 4.1 Ben-Israel D, Isaacs AM, Morrish W, Gallagher NC (2017). “Acute vertex epidural hematoma”. Surg Neurol Int. 8: 219. doi:10.4103/sni.sni_218_17. PMCΒ 5609442. PMIDΒ 28966825.
- β 5.0 5.1 Firsching R (2017). “Coma After Acute Head Injury”. Dtsch Arztebl Int. 114 (18): 313β320. doi:10.3238/arztebl.2017.0313. PMCΒ 5465842. PMIDΒ 28587706.
- β Chakraborty S, Dey PK, Chatterjee S (2015). “Cranial epidural hematoma related to an accidental fall from mother’s lap in a neonate”. J Pediatr Neurosci. 10 (1): 82β3. doi:10.4103/1817-1745.154370. PMCΒ 4395959. PMIDΒ 25878757.
- β Lee ST, Lui TN (1992). “Early seizures after mild closed head injury”. J Neurosurg. 76 (3): 435β9. doi:10.3171/jns.1992.76.3.0435. PMIDΒ 1738023.
- β Ulrich PT, Fuessler H, Januschek E (2008). “Acute epidural hematoma with infarction of the right hemisphere in a 5-month-old child: case report with a long-term follow-up and a review of the literature”. J Child Neurol. 23 (9): 1066β9. doi:10.1177/0883073808315411. PMIDΒ 18827272.
- β Fuchs EC, MΓΌller-Busch C, Amtenbrink V (1975). “[Prognosis and long-term prognosis of epidural haematoma (a study of 83 patients) (author’s transl)]”. Rehabilitation (Stuttg). 14 (2): 82β7. PMIDΒ 1233608.
- β Sakakibara R, Yamazaki M, Mannouji C, Yamaguchi C, Uchiyama T, Ito T; et al. (2008). “Urinary retention without tetraparesis as a sequel to spontaneous spinal epidural hematoma”. Intern Med. 47 (7): 655β7. PMIDΒ 18379155.
- β Jung SW, Kim DW (2012). “Our experience with surgically treated epidural hematomas in children”. J Korean Neurosurg Soc. 51 (4): 215β8. doi:10.3340/jkns.2012.51.4.215. PMCΒ 3377878. PMIDΒ 22737301.
- β 12.0 12.1 12.2 12.3 Haselsberger K, Pucher R, Auer LM (1988). “Prognosis after acute subdural or epidural haemorrhage”. Acta Neurochir (Wien). 90 (3β4): 111β6. PMIDΒ 3354356.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
