74 year old female presented after a fall from a standing height. The patient loss consciousness on the scene, but was waking up on the way to the hospital. In the ER she became less responsive and had to be intubated for a decreased level of consciousness.

CT head revealed findings consistent with an epidural hematoma. Unlike subdural hematoma, epidural hematoma is a collection of blood above the dura (hard membrane covering the brain). In almost all cases epidural hematoma collects between the skull and dura as a result of a traumatic head injury. Rupture of the arterial blood vessel leads to the hematoma formation. In some cases, the venous blood vessel or venous sinus could be damaged as well.

In many cases an epidural hematoma can exert pressure on the brain and lead to herniation. CT scan of the brain is the diagnostic technique of choice.

The treatment usually involves craniotomy and surgical removal of the hematoma. Most patients, if treated promptly, have good neurological outcome.