Epidural hematoma is a collection of blood above the dural cover and beneath the skull. It is usually a results of moderate trauma, usually in younger patients. This is so because the dura is only loosely adherent to the bone in young patients and relatively small pressure will result in its stripping and allow the collection of blood to develop. In older patients the dura becomes more adherent to the skull and thus cannot be stripped by the escaping blood in most instances.
Except in rare instances, the epidural hematoma requires rapid surgical evacuation. Delay in treatment will result in secondary brain damage caused by herniation as discussed previously. Since the blood is also almost always clotted, craniotomy is required for its evacuation. (See Chronic and Subacute Subdural Hematoma)
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