Chronic Epidural Hematoma

Abstract

Two cases of chronic epidural hematoma are reported. Case 1, a 15-year-old female, was admitted with complaints of mild headache and hyposmia, and with computerized tomography (CT) findings of suspected epidural mass. Thirty-six days before admission, she fell from a motorcycle. Surgery revealed that the mass was an epidural hematoma with calcification. Case 2, a 17-year-old male, was admitted as the CT scan revealed an epidural mass. Thirty-one days before admission, he was involved in a traffic accident. Neurological examination revealed mild left motor weakness. Surgery confirmed that the mass was an epidural hematoma. Many atypical epidural hematoma have been reported. Some cases were reported as chronic epidural hematoma, and the others were reported as delayed epidural hematoma. However, the difference between the chronic epidural hematoma and the delayed epidural hematoma is not clear. In this paper, the chronic epidural hematoma and the delayed epidural hematoma are determined as follows. 1) Chronic epidural hematoma: Time interval between injury and operation is 14 days or more. Chronically increased intracranial pressure (ICP) is the main sign in these cases. In some cases, no symptoms or signs are observed. The hematoma is accompanied by a membrane or calcification. 2) Delayed epidural hematoma: Time interval between injury and operation is within 14 days. The chief complaint is the progressive ICP elevation sign.