[Emergency scenario: epidural hematoma - evaluation and management]

The epidural haematoma (EDH) is a potentially life-threatening complication after severe traumatic brain injury (TBI). However, it also occurs after mild or moderate TBI. The EDH is characterized by a variable clinical presentation in the acute situation. If undetected and untreated the EDH may lead to progressive transtentorial herniation with loss of consciousness, pupillary dilation, and further neurologic deficits. Native CT-scanning remains the diagnostic gold standard in the emergency scenario. When an EDH is identified, an emergency craniotomy is indicated according to the clinical and radiological presentation. The clinical outcome depends on the time of treatment. Below, clinical presentation, diagnosis and relevant treatment modalities of the EDH are discussed.