From the Research
Epidural hematoma diagnosis relies on a combination of clinical assessment and neuroimaging, with the gold standard diagnostic test being a non-contrast CT scan of the head, as seen in the most recent study 1. The diagnosis of epidural hematoma involves:
- Clinical assessment, including symptoms such as headache, vomiting, altered mental status, pupillary abnormalities, and contralateral hemiparesis
- Neuroimaging, with CT scan being the preferred method, showing a biconvex (lens-shaped) hyperdense collection between the skull and dura mater, often associated with a skull fracture
- Laboratory tests, such as coagulation studies, to assess bleeding risk, although these are not diagnostic In cases where CT is unavailable, MRI can be used but is less practical in emergency situations. The most recent study 1 highlights the importance of prompt diagnosis and treatment, as epidural hematomas represent neurosurgical emergencies requiring rapid intervention, typically through surgical evacuation, to prevent herniation and death. Key findings from the study 1 include:
- The use of endovascular management, specifically embolization of the middle meningeal artery, as a safe and effective method to achieve size stabilization in nonsurgically treated acute epidural hematomas
- The importance of close neurological observation and serial CT scanning in patients with small to medium-sized epidural hematomas
- The need for surgical evacuation in patients with large epidural hematomas or those with significant mass effect or central lucent areas. Overall, the diagnosis and treatment of epidural hematoma require a multidisciplinary approach, with prompt recognition and intervention being critical to preventing morbidity and mortality, as emphasized in the study 1.