Delayed epidural hemorrhage in hypotensive multiple trauma patients

Despite the availability of high resolution computed tomography, severely head-injured patients often present diagnostic dilemmas. An initially negative computed tomographic scan in the presence of severe multiple trauma does not predict an uncomplicated course. Early repeat scanning should be considered. We present three cases of delayed epidural hemorrhage in multiple trauma patients who initially were hypotensive secondary to hypovolemia. Possible etiologies for the hemorrhage as well as a list of indications for repeat scanning in the posttraumatic period are discussed.