Hematoma

• is an extravasation of blood outside the blood

vessels, generally the result of hemorrhage. A
hematoma is a pocket or localized collection of
 blood usually in liquid form within the tissue. This
distinguishes it from an ecchymosis, which is the
spread of blood under the skin in a thin
layer,commonly called a bruise. Internal bleeding
is generally considered to be a spreading of blood
within the abdomen or skull, not within muscle.

Three Types of Hematomas

• Epidural Hematoma -between the skull and dura
mater
• Subdural Hematoma -between the dura mater and
arachnoid mater
• Intracerebral Hematoma –bleeding within the skull

Epidural hematoma (EDH)

• also known as extradural hematoma, is a
hemorrhage into the space between the dura and
the overlying calvarium. It is almost exclusively
caused by trauma. The morbidity and mortality
result from mass effect on the brain as the
hematoma grows and strips the dura away from the
skull. EDH in children is managed similarly to
adults, but it requires special knowledge of location
and clinical presentation. Prompt diagnosis is
critical to the successful management of EDH.

Historical features that may suggest an increased risk

of EDH include the following:
 • High risk mechanism such as fall from a significant
height
• any mechanism involving a motor vehicle
• direct blow to the temporal region, inflicted injury
• or unknown mechanism (which may represent
inflicted injury).
• Preexisting bleeding disorder

S/S OF Epidural Hematoma

• Headache
• Vomiting
• Impaired cognition
• Insomnia
• Paresthesias
• Restless leg syndrome
• Gait disturbances
• Apathy

Potential Complications
• Seizures
• Decreased LOC
• Coma

Medical Management
• Reestablish equilibrium
• Prevent secondary brain damage
• Treatments include airway management
 ( hyperventilation, fluid resuscitation, temperature
regulation and medications.)

Nursing Management
•