What are the treatments for epidural hematoma (EDH)?
What are the treatments for epidural hematoma (EDH)?
Epidural hematoma (EDH) usually is a medical emergency that requires immediate treatment. Signs you need surgery include:
- Presence of a severe headache.
- Decrease in brain function.
- Hematoma that is larger than the size of a pea at its thickest point.
Without surgery to relieve pressure on your brain, permanent brain injury or death can result.
Surgery
The preferred surgery is craniotomy and hematoma evacuation. This means removing a piece of your skull and removing the blood clot, stopping any obvious sites of bleeding then putting the skull bone back in place and securing it with tiny screws.
Another surgical approach is to drill one or more holes in your skull to drain the blood. Draining the blood relieves the pressure the blood buildup causes on the brain. The drain may be left in place for several days following surgery to allow the blood to continue draining.
If you have a spinal epidural hematoma, laminectomy may be performed. During a laminectomy, a small section of bone is removed. Removing bone relieves pressure on your spinal cord and nerve roots caused by the blood clot.
No surgery/conservative treatment
Sometimes small brain bleeds that aren’t causing pressure on the brain and only cause mild symptoms can be managed without surgery. Your body can absorb a small amount of blood over time, usually a few months. If you have a small brain bleed, you’ll be closely monitored with repeat head CT scans to make sure the hematoma is healing.
Medications
After surgery, your neurologist or neurosurgeon may prescribe medications to reduce inflammation and pressure within your brain. Medications that may be prescribed include mannitol, hypertonic saline and glycerol. An antiseizure medication may also be prescribed for some time. Seizures are sometimes a complication of head injuries.
Rehabilitation therapy
If you’ve experienced brain damage, your neurologist will order the needed therapy — physical therapy, occupational therapy and/or speech therapy.