Epidural (Extradural) Hematoma Treatment in Gurgaon

What is an Epidural Hematoma?

An epidural hematoma refers to a collection of blood that builds up between the skull (or vertebral canal) and the dura mater, the outermost meningeal layer. In simpler terms, it is blood trapped in the “epidural space” that exerts pressure on the brain or spinal cord.

Epidural hematomas are more frequently observed in adolescents and young adults, particularly males, due to the structural characteristics of the skull and dura in this age group. In contrast, the condition is less common in older adults, where the dura is more firmly attached to the skull.

The immediate effects on daily lifestyle can be significant. A patient may initially appear alert but can experience a rapid decline in neurological function within hours. Activities such as speaking, walking, maintaining balance, or staying conscious can be suddenly impaired. Without prompt treatment, the condition can lead to irreversible brain damage or death.

What are the Causes and Risk Factors of Epidural Hematoma?

Epidural hematoma symptoms often begin subtly but can escalate rapidly, significantly impacting the patient’s daily lifestyle. These effects can disrupt essential daily activities such as speaking, walking, decision-making, and consciousness. Early recognition of these symptoms is vital to prevent serious neurological damage and ensure timely treatment:

• Head Trauma and Skull Fractures

Direct trauma to the skull remains the most common cause. Fractures can disrupt blood vessels—particularly the middle meningeal artery—causing blood to pool between the skull and dura mater. This buildup quickly raises intracranial pressure.

• Road Traffic Accidents and Sports Injuries

High-impact collisions and blunt force injuries during contact sports frequently result in skull fractures or vascular damage. These scenarios are particularly common in younger, active individuals and often lead to acute neurological decline.

• Anticoagulant Use and Bleeding Disorders

Patients on blood thinners or those with underlying coagulopathies face a higher risk of uncontrolled bleeding after even minor head injuries. The reduced ability to clot can cause faster hematoma expansion and more severe outcomes.

• Age-Related Risk (Elderly and Young Adults)

Younger individuals are anatomically predisposed due to a less firmly attached dura. In the elderly, although the dura adheres more tightly, increased vessel fragility and the common use of anticoagulants elevate the risk in the event of trauma.

Additionally, in the spinal epidural hematoma variant, causes may include spontaneous bleeding in the epidural venous plexus, epidural catheter insertion or removal, spinal procedures (lumbar puncture, epidural anaesthesia), and vascular malformations.

What are the Signs and Symptoms of an Epidural Hematoma?

An epidural hematoma symptom often begins subtly but can escalate rapidly, significantly impacting the patient’s daily lifestyle. Early recognition of these symptoms is vital to prevent serious neurological damage and ensure timely treatment. Here are the epidural hematoma symptoms and spinal epidural hematoma symptoms:

• Brief Loss of Consciousness Followed by a Lucid Interval

A characteristic feature is an initial period of unconsciousness after the injury, followed by a temporary phase of alertness. During this interval, the patient may appear stable but is at risk of rapid deterioration, often without warning.

• Severe Headache, Nausea, and Vomiting

As intracranial pressure increases, the patient may experience intense headaches accompanied by nausea and episodes of vomiting. These effects interfere with the ability to focus, eat, rest, or perform basic tasks.

• Focal Neurological Deficits (Weakness, Speech or Vision Changes)

Depending on the location of the hematoma, the patient may develop muscle weakness, difficulty speaking, or visual disturbances. These deficits significantly impair mobility, communication, and interaction with the environment.

• Rapid Deterioration, Reduced Consciousness, or Seizures

In severe cases, the patient may quickly lose responsiveness or exhibit seizure activity. These developments signal a critical rise in brain pressure and require immediate medical intervention to prevent permanent disability or death.

How is an Epidural Hematoma Diagnosed?

Epidural hematoma diagnosis relies on a combination of clinical evaluation and advanced imaging techniques to confirm the presence and severity of bleeding. Rapid and accurate diagnosis is critical to guide treatment decisions and prevent further neurological decline, ensuring the best possible outcome for the patient:

• Clinical Neurological Examination and Triage

The diagnostic process begins with a detailed neurological assessment. Healthcare providers evaluate the patient’s level of consciousness, pupil responses, motor skills, and sensory function using tools like the Glasgow Coma Scale (GCS) to determine urgency and guide immediate care.

• CT Scan of the Head (First-Line Imaging)

A non-contrast CT scan of the head is the gold standard for rapid diagnosis. It reveals a characteristic biconvex, lens-shaped blood collection between the skull and dura mater, confirming the presence of an epidural hematoma.

• MRI and Angiography for Further Evaluation

In complex cases or when additional vascular details are needed, MRI and angiography provide high-resolution images to assess brain tissue, vascular injuries, and hematoma extent.

• Emergency Assessment Protocols

Emergency protocols prioritise quick triage, imaging, and neurosurgical consultation to expedite treatment and reduce the risk of complications or long-term neurological deficits.

What are the Different Treatment Options for Epidural Hematoma?

Epidural hematoma treatment involves both surgical and non-surgical approaches depending on the severity, size of the hematoma, and the patient’s neurological status. Prompt intervention is critical to relieve pressure on the brain, prevent further injury, and promote recovery. In all cases, the medical team aims to reduce secondary injury, maintain cerebral perfusion, and prevent herniation. Here are some options for hematoma treatment:

Non-Surgical Treatment Options

• Immediate Stabilisation (Airway, Breathing, Circulation)

The priority is stabilising the patient’s vital functions. Ensuring a clear airway, adequate breathing, and maintaining circulation are essential to prevent secondary brain injury. This supportive care is crucial before further diagnostic or surgical procedures.

• Management of Raised Intracranial Pressure (ICP)

Elevated ICP due to bleeding can worsen brain damage. Non-surgical management includes head elevation, osmotic agents like mannitol, and hyperventilation to reduce pressure temporarily. Close monitoring in an intensive care setting is vital during this period.

• Reversal of Anticoagulation and Blood Product Support

For patients on blood thinners or with clotting disorders, reversal agents or blood products may be administered to control ongoing bleeding. This step is critical to stabilise the hematoma and prepare the patient for possible surgical intervention.

Surgical Treatment Options

• Emergency Surgical Evacuation (Craniotomy)

A craniotomy is the most common surgical procedure for an epidural hematoma. It involves removing a section of the skull to access and evacuate the accumulated blood, relieving pressure on the brain. This procedure is urgent and often life-saving in cases with significant neurological impairment or large hematomas.

• Surgical decompression via Laminectomy

In case of spinal epidural hematoma, which occurs as a result of blood collecting in the epidural space around the spinal cord, that causes compression and potential neurological deficits such as weakness, numbness, or paralysis. Prompt diagnosis and intervention are critical to prevent permanent damage.

Surgical decompression via laminectomy is typically required to evacuate the hematoma and relieve pressure on the spinal cord. The urgency of surgery depends on the severity and progression of neurological impairment. In selected cases with minimal neurological effects, conservative management with close monitoring may be considered.

• Burr Hole Drainage in Selected Cases

In some situations where the hematoma is smaller or accessible, burr hole drainage may be performed. This minimally invasive technique involves drilling small holes in the skull to drain blood and reduce intracranial pressure. It may be used as a temporary or definitive measure depending on the patient’s condition.

Recovery and Rehabilitation After Epidural Hematoma Treatment

Epidural hematoma recovery is a critical phase that begins immediately after treatment and extends through rehabilitation. The patient’s outcome depends on the severity of the hematoma, the promptness of intervention, and any complications encountered.

Recovery aims to restore neurological function, reduce long-term impairments, and help the patient resume daily activities as fully as possible. While recovery timelines may vary, most improvement occurs in the first 6–12 months, but slower gains may persist beyond. The rehabilitation team plays a critical role in maximising functional outcomes and quality of life.

• Intensive Monitoring and Care: Close observation in a neurocritical care unit ensures any changes in neurological status are promptly addressed, preventing secondary brain injury.
• Physical Therapy: Focused on rebuilding strength, balance, and coordination, physical therapy helps patients regain mobility and independence.
• Occupational Therapy: This supports the patient in relearning daily tasks such as dressing, eating, and personal hygiene, promoting self-sufficiency.
• Speech and Cognitive Therapy: For patients experiencing speech or cognitive impairments, targeted therapies assist in improving communication skills and mental function.
• Psychological Support: Emotional and psychological counselling addresses anxiety, depression, or post-traumatic stress that may arise during recovery.
• Long-Term Follow-Up: Regular neurological assessments and imaging studies monitor healing progress and detect any delayed complications.

Epidural hematoma long-term effects may range from full recovery to persistent neurological deficits (weakness, sensory loss, cognitive impairment, seizures). The degree of recovery often depends on the severity and duration of compression before treatment.

Epidural Hematoma Prognosis, Survival Rate and Complications

The overall outcome of an epidural hematoma depends on how quickly the condition is identified and treated. When managed promptly, the epidural hematoma prognosis is generally favourable, especially in patients who arrive with minimal neurological impairment. However, delays in treatment can lead to serious, sometimes irreversible consequences.

The epidural hematoma survival rate is high when surgical evacuation occurs within the critical window, typically within a few hours of symptom onset. Factors such as the size of the hematoma, the patient's level of consciousness at admission, and associated injuries influence survival and long-term recovery.

Despite successful treatment, patients may face various challenges during recovery. Several complications of epidural hematoma can impact both short-term outcomes and long-term neurological health.

• Favourable Prognosis with Early Intervention: When diagnosed and treated promptly, many patients recover fully with minimal long-term impairment, particularly younger individuals with isolated injuries.
• Variable Survival Rate Based on Severity: The epidural hematoma survival rate exceeds 80% in patients who undergo timely surgery. However, the rate declines sharply in cases with delayed diagnosis, brain herniation, or low Glasgow Coma Scale scores at presentation.
• Neurological Deficits: In some cases, residual effects such as limb weakness, speech difficulties, or cognitive impairment may persist, affecting the patient’s ability to return to normal life.
• Post-Traumatic Seizures: Seizures can occur during the acute phase or as a delayed complication. These may require long-term antiepileptic medication and follow-up.
• Hematoma Recurrence or Incomplete Evacuation: Rarely, bleeding may recur or not be fully resolved during initial treatment, requiring further intervention.
• Infections and Surgical Site Complications: As with any cranial surgery, there is a risk of infection, wound healing issues, or cerebrospinal fluid leakage.
• Spinal Complications (in spinal epidural hematoma): If not treated early, spinal cord compression can result in paralysis, sensory loss, or bladder and bowel dysfunction.

Complications of Epidural Hematoma

Potential complications include:

• Brain herniation and fatal compression

• Persistent neurological deficits (motor/sensory impairment, cognitive dysfunction)
• Seizures (early or late)
• Recurrence of hematoma or rebleeding
• Infection (wound infection, meningitis)
• Hydrocephalus or cerebral edema
• Medical complications (pneumonia, DVT, multi-organ dysfunction)
• In the spinal epidural hematoma variant: permanent spinal cord injury, incontinence, neuropathic pain, limb paralysis

Given these risks, epidural hematoma recovery cannot be assumed; sustained monitoring, rehabilitation, and secondary prevention measures are essential to reduce long-term morbidity.

Why Choose Artemis Hospitals For Epidural Hematoma Treatment in Gurgaon?

Choosing the right medical facility is critical when dealing with time-sensitive conditions like an epidural hematoma. At Artemis Hospitals, patients benefit from a multidisciplinary approach, advanced neurosurgical expertise, and comprehensive post-treatment care — all under one roof. Our protocols ensure that no time is lost in diagnosis, surgical intervention, or rehabilitation. Key reasons to choose Artemis Hospitals include:

• 24/7 Emergency Neurosurgery and Trauma Care: Our neurosurgery and trauma teams are available round-the-clock to manage emergencies with precision and speed, ensuring that patients receive immediate attention from the moment they arrive.
• Advanced Neuroimaging and State-of-the-Art Operating Theatres: Equipped with high-resolution CT, MRI, and angiography systems, Artemis Hospitals enables rapid and accurate diagnosis. Our operating theatres are designed for complex cranial and spinal surgeries.
• Experienced Neurosurgeons and Dedicated Neurocritical Team: Our board-certified neurosurgeons bring decades of experience in managing critical brain and spinal conditions. A dedicated neurocritical care team monitors patients postoperatively to ensure stability and guide early recovery.
• Comprehensive Rehabilitation and Follow-Up Services: From inpatient rehab to long-term outpatient support, Artemis provides individualised therapy programs covering physical, occupational, cognitive, and psychological care, essential for full neurological recovery.
• Evidence-Based Treatment Protocols: All care is delivered according to globally recognised, evidence-based protocols, ensuring the highest standards in neurosurgical treatment and patient safety.

Book a Consultation for Epidural Hematoma Treatment at Artemis Hospitals in Gurgaon

If a patient is experiencing the effects of a head injury or has been diagnosed with an epidural hematoma, timely medical attention is critical. Artemis Hospitals Gurgaon offers expert-led care with advanced diagnostics, emergency neurosurgery, and comprehensive rehabilitation — all tailored to support a strong recovery.

Consult with our neurosurgical specialists or seek a second opinion. Contact Artemis Hospitals today. Early intervention can make the difference, book appointment now!

Reviewed By Dr. Anuvrat Sinha
Consultant Neurosurgery
Artemis Hospitals

Frequently Asked Questions

What is the immediate treatment for an epidural hematoma?

Immediate treatment focuses on stabilising the patient’s airway, breathing, and circulation, followed by rapid surgical evacuation of the hematoma to relieve pressure on the brain.

How does an epidural hematoma differ from a subdural hematoma?

An epidural hematoma occurs between the skull and the dura mater, usually due to arterial bleeding, while a subdural hematoma forms beneath the dura, often from venous bleeding.

When do we need surgery for an epidural hematoma?

Surgery is needed when the hematoma is large, causes neurological deficits, or leads to increased intracranial pressure. Early intervention improves survival and reduces complications.

What long-term complications may occur after an epidural hematoma?

Some patients may experience cognitive impairment, weakness, speech difficulties, or post-traumatic seizures, depending on the severity and location of the hematoma.

What is the survival rate for patients with epidural hematoma?

The survival rate is over 80% with timely surgical treatment. Delayed diagnosis or treatment significantly lowers the chances of full recovery.

Can an epidural hematoma be detected immediately after injury?

Yes, a CT scan can detect an epidural hematoma shortly after injury. Early imaging is crucial in patients with head trauma and neurological changes.

Can epidural hematomas be treated without surgery?

In select cases with small hematomas and no neurological deficits, non-surgical management with close monitoring may be considered, though surgery is often the standard.

Where can I find emergency treatment for an epidural hematoma near me?

Artemis Hospitals offer 24/7 emergency care and neurosurgical intervention for epidural hematomas, ensuring immediate treatment for head injury emergencies.

Which is the best hospital for epidural hematoma treatment near me?

Artemis Hospitals is among the best for epidural hematoma treatment, offering advanced neuroimaging, expert neurosurgeons, and comprehensive rehabilitation services.

How do I book an appointment with a brain specialist near me for head injuries?

You can book an appointment with a neurosurgeon at Artemis Hospitals through our website, helpline, or by visiting the emergency department directly.

Are there 24/7 emergency services for epidural hematoma in Gurgaon?

Yes, Artemis Hospitals Gurgaon provides round-the-clock emergency services and immediate access to neurosurgical care for patients with head injuries.

Which hospital near me offers craniotomy and burr hole surgery for hematomas?

Artemis Hospitals offers both craniotomy and burr hole procedures, depending on the severity and location of the hematoma, with expert neurosurgical teams available 24/7.

Can I get rehabilitation services at Artemis Hospitals after epidural hematoma surgery?

Yes, Artemis Hospitals provides comprehensive rehabilitation services, including physical, occupational, cognitive, and psychological therapy after surgery.