DRG Category: 70

Mean LOS: 7.4 days

Description MEDICAL: Nonspecific Cerebrovascular Disorders with Major CC

DRG Category: 955

Mean LOS: 12.8 days

Description SURGICAL: Craniotomy for Multiple Significant Trauma

classification section:



Epidural hematoma is a rapidly accumulating mass of blood, usually clotted, or a swelling confined to the space between the skull and the dura mater. It is usually found in the temporoparietal region where a skull fracture will cross the path of the middle meningeal artery or the dural branches. It is categorized as a focal brain injury, and it accounts for approximately 50% of all head injuries and 60% of the mortality rate in head-injured patients. If an epidural hematoma expands rapidly, such as when the bleeding is arterial in origin, the injury is potentially fatal. The accumulation of blood rapidly displaces brain tissue and can result in cerebral herniation downward into the posterior fossa or toward the midline into the tentorial notch. If the hematoma is evacuated and bleeding is controlled promptly, the patient's prognosis is good. Mortality rates range from 5% to 30%.

Generally, head trauma involves both a primary injury and a secondary injury. The primary injury results from the initial impact, which causes immediate neurological damage and dysfunction. The secondary injury follows the initial trauma and probably stems from cerebral hypoxia and ischemia, which lead to cerebral edema, increased intracranial pressure (ICP), and brain herniation.