Epidural Hematoma: Drug Therapy

Therapeutic targets

Emergency neurosurgical intervention is required to save the patient’s life:

  • Reduction of intracranial pressure and hematomevacuation (evacuation of the hematoma/bruise) (see “Surgical Therapy“).

Until then:

  • Secure and stabilize vital functions
  • Avoid secondary diseases and complications, e.g., posttraumatic cerebral edema
  • If necessary, normalization of blood clotting

Therapy recommendations

  • Preoperative intracranial pressure reduction:
    • Upper body elevation (10-30°).
    • Osmotherapy with a 20% mannitol solution (100-150 ml in 10-15 minutes).
  • To normalize blood clotting:
    • Fresh frozen plasma (FFP) – a blood product obtained from human donor blood, which contains the liquid and dissolved components of the blood; the cells of the blood (erythrocytes, leukocytes, platelets) have been largely removed by centrifugation; Caution: it should not be used without a clinically manifest bleeding tendency!
    • Vitamin K
    • Recombinant factor VIIa
  • Low-dose (75-300 mg/day) continuous medication with acetylsalicylic acid (ASA; antiplatelet agent), as prescribed in the primary and secondary prevention of vascular events, does not increase the risk of intracranial hemorrhage.