Epidural hematoma terjadi pada 1% trauma kepala, insiden tertinggi terjadi pada usia 2030 tahun, jarang terjadi pada usia dibawah 2 tahun atau lebih dari 60 tahun, disebabkan dura yang melekat erat pada tabula interna skull. Pendahuluan epidural hematom adalah salah satu jenis perdarahan. Pathophysiology unlike in epidural hematomas, sdh usually results from the tears in veins. Ctguided percutaneous intraspinal needle aspiration for. Top of skull is removed to reveal middle meningeal artery which has emerged from foramen spinosum to branch over surface of dura.
Edh results from traumatic head injury, usually with an associated skull fracture and arterial laceration. T he mortality of patients operated on for epidural hematoma ranges from 12% to 30% in most series. Epidural hematoma adalah hematoma antara tengkorak dan duramater. The purpose of this study is to identify the clinical. The reported incidence of delayed epidural hematoma varies from 5. Treatment consists of making openings through the skull burr holes to decrease icp emergently, remove the clot, and control the bleeding.
Epidural hematoma after spinal or epidural anesthesia has been acknowledged as a rare but a serious complication, which may cause permanent neurologic deficits even though emergency laminectomy is performed. Epidural hematoma is an indication for emergency neurosurgical intervention. Epidural hematoma gejala, penyebab dan mengobati alodokter. Extradural hematoma edh, also known as an epidural hematoma, is a collection of blood that forms between the inner surface of the skull and outer layer of the dura, which is called the endosteal layer. Edh terjadi pada sekitar 2% pada pasien dengan cedera kepala dan 515% pada pasien dengan cedera kepala yang fatal. A slow progression of bleeding and increased icp b venous bleeding from bridging veins c lucid interval immediately after injury followed by rapid decline in level of consciousness d extensive primary injury to neuronal structures. Edh merupakan komplikasi cedera kepala yang serius yang membutuhkan diagnosis segera dan tindakan intervensi bedah. Minor subdural hematomas ct showing a subdural hematoma in the anterior portion of the skull and soft tissue swelling on the left posterolateral surface. This condition is an extremely rare postoperative complication of ventriculoperitoneal shunt and contralateral decompressive craniectomy. A literature search was performed using pubmed and ovid to identify articles pertaining to ssehs. A spinal hematoma is a collection of blood that occurs between the dura mater and the spine. To the best of our knowledge, this is the first case report of crosssectional imaging appearance of epidural hematoma associated with sinusitis and epidural abscess.
The lucid interval associated with epidural bleeding. An epidural hematoma occurs when a mass of blood forms in the space between your skull and the protective covering of your brain. This type of subdural hematoma is among the deadliest of all head injuries. Spontaneous resolved cervical spine epidural hematoma. An epidural hematoma can be diagnosed using advanced imaging technologies. Jan 26, 2018 subdural hematoma sdh and epidural hematoma edh are characterized by bleeding into the spaces surrounding the brain or spinal cord. This technology is commonly used to diagnose the location and size of the epidural hematoma. Surgical management of acute epidural hematomas request pdf. The posterior fossa is a rare location for traumatic injury, in general, including edh epidural hemorrhage epidural hematoma, extradural hemorrhage, or hematoma bleeding outside the outermost layer of the dural mater, which is thus stripped away from the. The hematoma is denser and homogenous so easily identified.
It is a rare but potentially devastating complication of spinal and epidural anesthesia with an incidence of epidural hematoma edh is a traumatic accumulation of blood between the inner table of the skull and the stripped off dural membrane and predominantly consists of venous blood in infants. The traumatic epidural hematoma tedh volume is often used to assist in tedh treatment planning and outcome prediction. Cervical spine epidural hematomas cseh are rare, and surgical intervention is typically required. Acute subdural hematoma after a reported mild concussion. Epidural hematoma an overview sciencedirect topics. Epidural hematoma is when bleeding occurs between the tough outer membrane covering the brain dura mater and the skull. Abc2 is a wellaccepted volume estimation method that can be used for tedh volume estimation. A subdural hematoma subdural hematoma sdh is a form of traumatic brain injury in which blood gathers between the dura the outer protective covering of the brain and the arachnoid the middle layer of the meninges. Epidural and subdural hematomas flashcards quizlet. Epidural hematoma knowledge for medical students and physicians.
Similarly, we observed progressive epidural hematoma in 9. Although surgery remains the treatment of choice for extradural hematomas edh, there were many cases reported in the literature with good outcome, even if they were not treated surgically. Epidural hematoma adalah kondisi di mana darah masuk dan menumpuk pada ruang yang ada di antara tulang tengkorak dan lapisan yang menyelimuti otak atau disebut dura. Another test that may be used is the magnetic resonance imaging mri scan. In 1751, james hill, from dumfries, scotland, described the first hematomarelated lucid interval in a patient with a subdural hematoma. A total of 76 consecutive patients who underwent emergency craniotomy for acute traumatic epidural and subdural haematoma at. A spinal subdural or epidural hematoma is an accumulation of blood in the subdural or epidural space that can mechanically compress the spinal cord. Hematoma epidural dapat terjadi pada siapa saja dan umur berapa saja, beberapa keadaan yang bisa menyebabkan epidural hematom adalah misalnya benturan pada kepala pada kecelakaan motor. Progressive epidural hematoma in patients with head trauma. Pdf bilateral epidural hematomas are very rare and are associated with high mortality. Intracerebral hemorrhage the numbers current status recent updates the future. Epidural hematoma edh is an easily treated form of head injury that is often associated with a good prognosis. T1 weighted mri showing an older subdural hematoma on the left and a newer one on the right.
Epidural hematoma edh adalah perdarahan intrakranial yang terjadi diantara duramater dan tulang. Percentage distribution of site of epidural hematoma. Epidural hematoma ie, accumulation of blood in the potential space between dura and bone may be intracranial edh or spinal sedh see. It is usually found in the temporoparietal region where a skull fracture will cross the path of the middle meningeal artery or the dural branches. Epidural hematoma after epidural anesthesia in a patient. Epidural hematom adalah perdarahan intrakranial yang terjadi karena fraktur tulang tengkorak dalam ruang antara tabula interna kranii dengan duramater hematoma epiduralmerupakan gejala sisa yang serius akibat cedera kepala dan menyebabkan angka mortalitas sekitar 50%. Epidural hematoma free download as powerpoint presentation. Outcome after acute traumatic subdural and epidural hematoma in. Sdhs form between the dura and the arachnoid membranes edhs arise in the potential space between the dura and the skull.
All structured data from the file and property namespaces is available under the creative commons cc0 license. Pdf progressive epidural hematoma in patients with head. Penyakit epidural hematoma gejala, penyebab, dan cara. Files are available under licenses specified on their description page. The inciting event often is a focused blow to the head, such as that produced by a hammer or baseball bat. The bleeding fills the brain area very rapidly, compressing brain tissue. Spinal epidural hematoma seh is a rare neurosurgical emergency. Often there is loss of consciousness following a head injury, a brief regaining of consciousness, and then loss of consciousness again.
Epidural hematoma after routine epidural steroid injection. The blood from the ruptured vessel collects between the skull and dura. Trauma or other injury to your head can cause your brain to bounce. Nov 02, 2015 epidural haematoma extradural haemorrhage 1. Spinal epidural hematoma peaks during the fifth and sixth decades. Edema and secondary neuronal injury in perihematomal region surrounding the hematoma 4. Hematoma epidural terjadi akibat trauma kepala, yang biasanya berhubungan dengan fraktur tulang tengkorak dan laserasi pembuluh darah. In rare instances, such hemorrhages can be spontaneous. Feb 28, 2019 selain gejala seperti di atas, epidural hematom dapat menyebabkan berbagai komplikasi jika tidak diobati. Hematoma epidural adalah pdf epidural hematoma edh is an intracranial hemorrhage between the outer membrane of the brain dura mater and the skull, usually caused by trauma. This condition is an extremely rare postoperative complication of ventriculoperitoneal shunt and contralateral.
The methods used for identification of the epidural space are important for good quality of anaesthesia and for avoidance of complications such as epidural haematoma i. However, epidural hematoma can occur after the procedure by various mechanisms, which can cause serious complications. Epidural hematoma, a type of head injury involving bleeding into the space between the skull and the dura mater, the outermost layer of the protective structures surrounding the brain. Epidural hematoma is a rare event after spinal or epidural anesthesia in healthy patients without coagulopathy or traumatic needle insertion. Other symptoms may include headache, confusion, vomiting. Traumatic extradural haematomas edhs comprise 1 to 3% of all head trauma admissions. Differential diagnosis of epidural lesion of the spine. The risk of these events is increased by the use of indwelling epidural catheters for administration of analgesia or by the concomitant use of drugs affecting hemostasis such as non. A 22yearold male patient was admitted to our clinic with headache and a decline in. We present a case of a healthy patient who experienced an acute lumbar epidural hematoma after epidural anesthesia for an outpatient knee arthroscopy. Epidural hematoma edh is defined as hemorrhage into the potential space between the dura, which is inseparable from cranial periosteum, and the adjacent bone. Trauma or other injury to your head can cause your brain to bounce against the inside of your skull.
Hematoma epidural dapat terjadi pada siapa saja dan umur berapa saja, beberapa keadaan yang bisa menyebabkan edh adalah misalnya benturan pada kepala pada kecelakaan motor. On ct, the hematoma forms a hyperdense biconvex mass. A computerized tomography ct scan produces a detailed picture of the brain using xrays. The fractured bone lacerates a dural artery or a venous sinus. Subdural hematoma a subdural hematoma sdh is a form of traumatic brain injury in which blood gathers between the dura and the arachnoid. An epidural hematoma is considered an extreme emergency, marked neurologic deficit or even respiratory arrest can occur within minutes. Subdural hematoma sdh and epidural hematoma edh are characterized by bleeding into the spaces surrounding the brain or spinal cord. Pdf progressive epidural hematoma pedh after head injury is often. Download this pdf file majalah kedokteran andalas unand. Epidural hematoma is when bleeding occurs between the tough outer membrane covering the.
Epidural hematoma after outpatient epidural anesthesia. Epidural haematoma extradural haemorrhage slideshare. Computed tomography of epidural hematomas sage journals. Messerer m1, dubourg j, diabira s, robert t, hamlat a. The brain and spinal cord, essentials of roentgen interpretation, fourth edition. Epidural hematoma subdural hematoma subarachnoid hemorrhage. Epidural hematomas have a fast insidious onset and usually follow a pattern like the one described in the scenario. Epidural hematoma as a complication of sphenoid sinusitis and. This often results in brain injury and may lead to death. Ligia tataranu 1,2, vasile ciubotaru 2, dan paunescu 2, andrei spatariu 2, mugurel radoi 1 abstract. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Pdf abstrak epidural hematoma akut merupakan suatu keadaan yang urgent dan serius. A subdural hematoma is most often the result of a severe head injury. Spinal subdural or epidural hematoma neurologic disorders.
It often occurs when an impact fractures the calvarium. Masuknya darah ke ruang tersebut disebabkan oleh adanya cedera kepala yang menimbulkan keretakan tulang tengkorak, kerusakan atau sobeknya lapisan dura, atau pembuluh darah otak. All patients had minimal to mild neurologic deficit. Typical symptoms are due to compression of the brain and appear after a lucid interval that follows an initial loss of consciousness. An epidural hematoma edh is bleeding between the inside of the skull and the outer covering of the brain called the dura. It can occur when a traumatic force applied to the head is sufficient to cause a deformity of the skull and damage. Incidence of epidural hematoma, infection, and neurologic. Advances in contemporary ct imaging have made confirmation of an edh diagnosis rapid and accurate. But an epidural hematoma is caused by arterial bleeding where as subdural are venous. Diagnosis is by mri or, if not immediately available, by ct myelography.
There are few reported cases of an epidural spinal hematoma following interventional pain procedures. Spinal epidural hematoma occurring at a distance from the transforaminal epidural injection site. Epidural hematoma atau perdarahan extradural adalah kondisi saat darah mengumpul di area epidural, yaitu area di antara tulang tengkorak dan lapisan duramater. Hematoma epidural biasanya disebabkan oleh trauma kepala, dan sering dikaitkan dengan fraktur tulang tengkorak. Further expansion due to osmosis in some subdural bleeds, the arachnoid layer of the meninges is torn local. An otherwise healthy athlete suffered a re ported mild concussion, and.
The most common cause of intracranial epidural hematoma is trauma, although. Doc laporan pendahuluan epidural hematoma edh desti. Risk of epidural hematoma after neuraxial techniques in. Hematoma wikipedia bahasa indonesia, ensiklopedia bebas. Transforaminal epidural steroid injection tfesi is a conservative method to treat back pain due to radiculopathy. Previous reports have highlighted the substantial risk of this complication in patients receiving the subsequent anticoagulant or antiplatelet therapy. Epidural hematoma knowledge for medical students and. In our study, pedh was defined as an appearance of new hematoma, or a 25% or more unequivocal increase in the size of hematoma during hospitalization.
Epidural hematoma definition of epidural hematoma by. Mar 30, 2020 hematoma epidural adalah pdf epidural hematoma edh is an intracranial hemorrhage between the outer membrane of the brain dura mater and the skull, usually caused by trauma. An epidural hematoma is usually associated with a skull fracture. Head injury definition a history of a blow to the head or the presence of a scalp wound or those with evidence of altered consciousness after a relevant injury. Epidural hematoma in the brain is rare in patients older than age 60. The availability of computed tomography has increased the. Epidural hematoma accumulation of blood within the epidural space of the spine may be developed after trauma, after surgery, by complication of anticoagulants, or spontaneously. Oct 27, 2016 epidural hematoma edh is a traumatic accumulation of blood between the inner table of the skull and the strippedoff dural membrane. Hematoma adalah sekelompok sel darah yang telah mengalami ekstravasasi, biasanya telah menggumpal, baik di dalam organ, interstitium, jaringan dan otak. This case details the possible relationship between a reported mild concussion and an acute subdural hematoma in a football athlete.
Other symptoms may include headache, confusion, vomiting, and an inability to move parts of the body. Epidural hematoma secondary to frontal sinusitis has been described previously in the literature. We report a case of a spinal epidural hematoma in a patient with no known risk factors e. The morbidity and mortality result from mass effect on the brain as the hematoma grows and strips the dura away from the skull. Apr, 2016 epidural hematoma edh is an easily treated form of head injury that is often associated with a good prognosis. A 44yearold female with cervical myelopathy presented with a mild quadriparesis following manipulation by a chiropractor. Some studies estimate the overall risk of epidural hematoma associated with neuraxial techniques in obstetric patients to be approximately 1. Epidural hematoma represents acute bleeding into the epidural space. It occurs approximately 2% of all cases of head trauma. The space occupied by epidural hematoma is limited by adherence of dura to the inner table of the skull, especially at the sutural lines, which contributes to the lenticular or biconvex appearance in the ct scan. The study aims to assess the outcome of pediatric edh using kings outcome scale for.
Epidural hematoma definition and patient education. This can tear your brains internal lining, tissues, and blood vessels. Concussion grading scales and returntoplay guidelines are also discussed. However, these studies were performed in the prect scan era. Hematoma epidural adalah perdarahan intrakranial yang terjadi karena. Although surgery remains the treatment of choice for extradural hematomas edh, there were many cases. Hemorrhage into the spinal canal most commonly occurs in the epidural space because of the prominent epidural venous plexus. Correlation of severe head injury epidural hematoma trepanation respond time. Epidural hematoma is a rapidly accumulating mass of blood, usually clotted, or a swelling confined to the space between the skull and the dura mater. Gejala hematoma epidural dapat berupa sakit kepala, kejang, mual, muntah atau defisit neurologis focal. Review the current literature regarding spontaneous spinal epidural hematomas ssehs and report on the known risk factors, evaluation, and treatment of this rare entity. This is inadequate to produce a robust estimate of event rates. Jan 22, 20 the answer choices are misleading since both epidural and subdural hematomas are technically intracranial hemorrhages. A large biconvex epidural hematoma in the left frontotemporal region causing mass effect, midline shift and subfalcine herniation there is a linear fracture in the temporal and frontal bone in addition to a right blowout fracture of the orbit with fat herniation.
Hematoma epidural adalah pdf epidural hematoma edh is an intracranial hemorrhage between the outer membrane of the brain dura mater and. The first case of a lucid interval associated with an edh was described by john abernethy. Here, we present the rare case of a cseh resulting from chiropractic manipulation successfully treated conservatively. Typical symptoms are due to compression of the brain and appear after a lucid interval that. Unlike in epidural hematomas, which are usually caused by tears in arteries, subdural bleeding usually results from tears in. Spinalepidural hematomas when neuraxial anesthesia epidural spinal anesthesia or spinal puncture is employed, patients anticoagulated or scheduled to be anticoagulated with low molecular weight heparins, heparinoids or fondaparinux sodium for prevention of. Edh can occur intracranially or intraspinally and can result in clinically significant morbidity andor mortality if it is not diagnosed and treated promptly. Ovoid or fusiform shape lesion may be seen in normally fatfilled epidural space. Association with intracranial lesions and clinical correlation. Mar 26, 2019 epidural hematoma edh, also known as extradural hematoma, is a hemorrhage into the space between the dura and the overlying calvarium. Results in the four cases with epidural abscesses, ctguided aspiration showed purulent material confirming diagnosis and the culture specimen determined the causative agent. Epidural hematoma history trauma etiology laceration of middle meningeal artery finding lensbiconvex shape hyperdensity midline shift no cross suture mass effect ventricular compression displacement of grey white interface take home message. Epidural hematoma occurs as a result of head trauma and subsequent acute hemorrhage, primarily from the middle meningeal artery between the skull and the dura mater.
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