Surgery is the mainstay of treatment for epidural hematoma. An epidural hematoma greater than 30 cm3 should be surgically evacuated regardless of the patient’s Glasgow Coma Scale (GCS) score. An epidural hematoma less than 30 cm3 and with less than a 15-mm thickness and with less than a 5-mm midline shift in patients with a GCS score greater than 8 without focal deficit can be managed nonoperatively with serial computed tomographic scanning and close neurological observation in a neurosurgical center. Acute epidural hematoma with a small amount of bleeding(less than 50 mL)may be treated by minimal invasive surgery methods which avoids craniotomy.

• An epidural hematoma greater than 30 cm3 should be surgically evacuated regardless of the patient’s Glasgow Coma Scale (GCS) score. An epidural hematoma less than 30 cm3 and with less than a 15-mm thickness and with less than a 5-mm midline shift in patients with a GCS score greater than 8 without focal deficit can be managed nonoperatively with serial computed tomographic scanning and close neurological observation in a neurosurgical center.^[1]

• Surgery is the mainstay of treatment for epidural hematoma.^[2][3][4]
• An epidural hematoma greater than 30 cm3 should be surgically evacuated regardless of the patient’s Glasgow Coma Scale (GCS) score. An epidural hematoma less than 30 cm3 and with less than a 15-mm thickness and with less than a 5-mm midline shift in patients with a GCS score greater than 8 without focal deficit can be managed nonoperatively with serial computed tomographic scanning and close neurological observation in a neurosurgical center.^[1]
• For patients with slowly-developing epidural hematoma in the context of impaired coagulation, burr-hole evacuation and drainage may be a less invasive method of treatment compared to conventional craniotomy.^[3]
• Acute epidural hematoma with a small amount of bleeding(less than 50 mL)may be treated by minimal invasive surgery methods which avoids craniotomy.^[5]