Chronic epidural haematoma: a report of 10 cases and review of the literature

Progressive Epidural Hematoma in Patients with Head Trauma: Incidence, Outcome, and Risk Factors

“…A well recognized secondary insult of TBI is epidural hematoma (EDH), which is classically considered to be an acute complication of TBI whose maximum development takes place immediately following trauma [1]. However, there are also many reported cases of delayed/progressive epidural hematoma or very rare chronic epidural hematoma [2–4]. …”

Chronic Extradural Hematomas: An Illustrative Case Report and Review of Literature

“…12 The larger extradural hematomas (volume > 30 cc, midline shift > 5mm, and clot thickness >15 mm) usually being symptomatic get evacuated early by craniotomy, whereas the smaller asymptomatic ones are managed conservatively with close observation. 13,14 The extradural hematoma, if not evacuated surgically may either get absorbed and disappear in 3 to 15 weeks, 15 or get encapsulated and persist, 16 or get calcified, 17 or may enlarge due to repeated oozing from inner table of skull, dural surface vessels, or from hematoma membranes. [17][18][19] Resorption process of extradural hematomas is likely to be similar 12,20 but slower and less efficient 21 than subdural hematomas due to presence of lesser absorptive surfaces (fibrous dura mater on one side and bone on the other side).…”

“…Neomembrane/capsule formed in CEDH histopathologically resembles the chronic subdural membrane. 14,20,22 Liquefaction of clot occurs in a predictable time course and can be identified by CT scan. 12 However, liquefaction of CEDH is never complete, and it would not be very accurate to assess the age of hematoma on the basis of its consistency found intraoperatively.…”

“…However, there is no consensus on the precise time-based definition of chronic epidural hematoma; with injury to detection/ operation time gap varying from 48 hours to 2 weeks in different studies available in literature. 14,26…”

“…It occurs more commonly in the younger (<40 years) age groups. 14,29 Some of them are identified incidentally, whereas others are diagnosed while investigating for persistent and/or progressive symptoms like headache, dizziness, nausea, vomiting, memor y impairment, hemiparesis, and disturbance of consciousness. Some are initially small but may enlarge slowly and present with delayed neurological deterioration due to persistent slow and active bleeding.…”