LAUSR

BACKGROUND Epidural hematoma (EDH) can result in a catastrophic outcome of traumatic brain injury. Current management guidelines do not consider the source of hemorrhage in the decision making. The purpose of this study is to examine the relationship between EDH location and its source of hemorrhage. METHODS We report retrospectively reviewed, prospectively obtained surgical data of patients with acute, traumatic cranial EDH treated between 2007-2018. Computed tomography (CT) scans were used to categorize EDH location as lateral and medial. Source of hemorrhage was identified intraoperatively by a single surgeon. RESULTS Overall, of 92 evacuated EDH (in 87 patients), 77.2% were in the lateral location (n=71). Of lateral EDH, 63.4% were the result of arterial bleeding, while 9.2% of the medial EDH were due to arterial bleed (p<0.0001). In the instance where surgery was done primarily to treat EDH, 65.3% had an arterial bleed source (p<0.0001). In those treated for primary reasons other than EDH evacuation, 75% that had a venous bleed source (p=0.002). CONCLUSIONS The location of EDH correlates with source of hemorrhage. The decision to operate on EDH may be influenced by this factor.