Symptoms | Epidural bleeding

Symptoms

Typical for an acute arterial epidural hemorrhage in the brain is the development of symptoms after a brief fainting (syncope). After regaining consciousness, a phase of symptomlessness may follow in which the patient clears up and complains of headaches only. These worsen dramatically in the course of time and are accompanied by psychological agitation of the patient and possibly nausea and vomiting.

As the symptoms develop, there is a renewed clouding of consciousness, the patient becomes drowsy and is less and less responsive. Within the first two hours after the injury, increasing compression of brain parts and nerves occurs as the bleeding expands. Thus, the pressure on the oculomotor nerve and the pupil on the bleeding side (homolateral mydriasis) increases.

This leads to movement disorders or paralysis on the opposite side of the body (contralateral hemiparesis). Chronic epidural bleeding also occurs rarely. The symptoms develop very slowly and can take weeks or even months.

Patients report constant headaches and dizzy spells, often appear confused, disoriented and dazed. In older patients, these can also be signs of developing dementia, which diagnostically leads the doctor to take the wrong path and sometimes allows the correct diagnosis of epidural bleeding only at a late stage. A special symptomatology must be considered in small children.

Epidural hematomas are not uncommon at a young age, even after falls from a low height. However, the skull bone is sometimes relatively stretchy because the children’s fontanelles are not yet closed. The first disturbances of consciousness therefore only occur 6 to 12 hours after the accident.

Due to the relatively large head of children, the blood loss into the epidural space can take on relevant dimensions. This can lead to anemia and the associated drop in blood pressure.If the bleeding does not occur intracranially, but in the area of the spine, the clinical picture changes fundamentally. Consciousness is not affected and the patient is usually clear, if there is no additional impairment of the brain (which may be possible in an accident or similar). Usually there is pain at the site of the bleeding and in the further course of the disease, there are corresponding failures below the injured area. This can lead to a complete or incomplete cross-sectional syndrome in which the patient loses the ability to move, among other things.