Extradural Hematoma: Treatment, Cost and Side Effects

Extradural hematoma is also known as epidural hematoma wherein blood accumulates in between the tough protective covering membrane of the brain and the skull. The accumulation occurs because of a trauma or head injury resulting in a friction or bouncing of the brain’s inner lining against the hard skull. Due to this the inner membrane, blood vessels and the tissues tear off resulting in bleeding. The bleeding amount depends upon the intensity of the trauma. The blood then not only gets accumulated but also forms a mass and usually attains a biconvex shape. This mass of blood is called hematoma which exerts pressure on the brain causing it to swell. Complications arising due to the pressure on the brain affect speech and vision along with body’s movement and consciousness. A person starts experiencing the symptoms just a few minutes or may be a few hours after sustaining the injury. The symptoms that prove the person has got a hematoma in the brain are dizziness, confusion, severe headache, drowsiness, nausea and vomiting, shortness of breath, loss of vision on one side, enlarged pupil, weakness and seizures. The person may become unconscious for a short time period and can also go into coma. Treatment for extradural hematoma is an emergency requirement as it can result in death if left untreated. Treatment options for extradural hematoma are surgery, medication or rehabilitation therapy. The treatment option required will depend upon the severity of the injury sustained. If the severity is too high, even with treatment disability due to brain damage can affect for a very long time. A quick treatment decision saves the person from more serious disabilities and death.

If a person sustains severe head injury he/she will start experiencing the signs and symptoms of hematoma after a few minutes or hours after the incident. The hematoma is bound to put pressure on the brain thereby causing serious complications. This will require the person to consult a doctor as soon as possible to avoid further complications and death. If an extradural hematoma is suspected, the doctor may recommend diagnostic tests like neurological tests, computed tomography (CT) scans, magnetic resonance imaging (MRI) for examining the soft tissue of the brain and the skull and electroencephalogram (EEG) to monitor the electrical activity of the brain. Treatment for extradural hematoma involves surgery, medication and rehabilitation therapy. Surgery is the preferred treatment option to remove the extradural hematoma. The surgical removal may be of two types- craniotomy and aspiration. In craniotomy the brain is opened up to remove the accumulated biconvex mass of blood thereby reducing the pressure. Aspiration may be done by drilling a burr hole on the skull to suck out the small solid accumulation of blood. Treatment with medication is attempted before surgery to reduce intracranial pressure and inflammation in the brain. Some hyperosmotic agents like hypertonic saline, mannitol and glycerol are used as medication. Medication is also prescribed after hematoma removal with surgery. They are anti-seizure medication which may be required for several months and years to prevent seizures. The patient might also be recommended to go for rehabilitative therapy that includes several exercises to manage the disabilities caused by the head injury like paralysis and difficulty in moving and weakness in any part of the body.

Any person who has received a severe head injury and experiences the signs and symptoms of extradural hematoma will be eligible for its diagnostic test like a CT scan or MRI or EEG. If a hematoma is diagnosed, the person will be eligible for treatment.

Person whose diagnostic test does not prove a hematoma will not be eligible for the treatment.

Yes, there are side effects of hyperosmotic medications but they are minor and cause only abdominal pain, nausea and vomiting which go away on their own after some time. The extradural hematoma surgery can have a few side effects like weakness, fits, lack of co-ordination etc.

After the treatment for extradural hematoma is done, the patient must have ample amount of rest, avoid alcohol and increase the activity level gradually.

It usually takes about 6 months to recover from extradural hematoma injury after its treatment.

The cost of treatment for extradural hematoma in India ranges from Rs. 500 to Rs. 1 lakh including consultation, medication and surgery.

Yes, the results are permanent.

There is no alternative to the treatment.