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Hematomas, Epidural and Subdural, Sports Medicine

Greg Nakamoto, MD, FACP Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Both epidural hematoma (EDH) and subdural hematoma (SDH) are structural brain injuries that can result from traumatic brain injury (TBI). However, they can follow different courses a...

DIAGNOSIS

Prehospital: 
  • EDH: <50% of the patients have the classically described “lucid interval” that is commonly associated with EDH 1:

    • Patient suffers TBI, which is often followed by an initial pe...

TREATMENT

In addition to the primary structural injury caused by TBI, neurotrauma also results in an inflammatory response that causes secondary brain injury. Targeting elements that are believed to c...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • EDH: In the case of nonsurgical EDH, the consulting neurosurgeon may consider discharge if the patient is neurologically stable after some period of observation. ...

REFERENCES

1
Bullock MR, Chesnut R, Ghajar J, et al. Surgical management of acute epidural hematomas. Neurosurgery.  2006;58(Suppl 3):S7–S15.
2
Bullock MR, Chesnut R, Ghajar J, et al. Surgical manag...

ADDITIONAL READING

Servadei F, Compagnone C, Sahuquillo J. The role of surgery in traumatic brain injury. Curr Opin Crit Care.  2007;13(2):163–168. 

CLINICAL PEARLS

  • EDH and acute SDH are neurosurgical emergencies that merit rapid neurosurgical evaluation.

  • CT is the study of choice in evaluating intracranial lesions in a patient with head injury 1,2...

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