● Epidural hematomas are located between the inner table of the skull and the dura.
● They are typically biconvex in shape because their outer border follows the inner table of the
skull and their inner border is limited by locations at which the dura is firmly adherent to the
skull.
● Epidural hematomas are usually caused by injury to an artery, although 10% of epidural
hematomas may be venous in origin.
● The most common cause of an epidural hematoma is a linear skull fracture that passes
through an arterial channel in the bone.
○ The classic example of this is the temporal epidural hematoma caused by a fracture through
the course of the middle meningeal artery.
● Epidural hematomas, especially those of arterial origin, tend to enlarge rapidly.
○ Most frequent site: temporal (middle meningeal artery torn)
Symptoms of epidural hematoma
● Headache
● Nausea/vomiting
● Seizures
● Focal neurologic deficits (eg, visual field cuts, aphasia, weakness, numbness)
● Spinal epidural hematoma typically causes severe localized back pain with delayed radicular
radiation that may mimic disk herniation.
Associated symptoms may include the following:
● Weakness
● Numbness
● Urinary incontinence
● Fecal incontinence
● They are typically biconvex in shape because their outer border follows the inner table of the
skull and their inner border is limited by locations at which the dura is firmly adherent to the
skull.
● Epidural hematomas are usually caused by injury to an artery, although 10% of epidural
hematomas may be venous in origin.
● The most common cause of an epidural hematoma is a linear skull fracture that passes
through an arterial channel in the bone.
○ The classic example of this is the temporal epidural hematoma caused by a fracture through
the course of the middle meningeal artery.
● Epidural hematomas, especially those of arterial origin, tend to enlarge rapidly.
○ Most frequent site: temporal (middle meningeal artery torn)
Symptoms of epidural hematoma
● Headache
● Nausea/vomiting
● Seizures
● Focal neurologic deficits (eg, visual field cuts, aphasia, weakness, numbness)
● Spinal epidural hematoma typically causes severe localized back pain with delayed radicular
radiation that may mimic disk herniation.
Associated symptoms may include the following:
● Weakness
● Numbness
● Urinary incontinence
● Fecal incontinence
