TRAUMATIC EXTRADURAL HEMATOMA: AN INTEGRATIVE REVIEW OF ANATOMICAL, CLINICAL, AND PROGNOSTIC ASPECTS

Abstract

Traumatic brain injury (TBI) is an important cause of morbidity and mortality, especially among young individuals. Among its complications, extradural hematoma (EDH) stands out as a neurosurgical emergency characterized by the accumulation of arterial blood between the dura mater and the calvaria, with a risk of rapid neurological deterioration. The objective of this study was to analyze the anatomical and clinical presentation of EDH, as well as its prognosis and the effectiveness of surgical management. This is an integrative literature review conducted in the PubMed and Virtual Health Library (VHL) databases. The descriptors used were "Hematoma, Epidural, Cranial" and "Brain Injuries, Traumatic," combined with the Boolean operator “AND.” Full-text studies published between 2021 and 2026, in English or Portuguese, were considered, and after screening to exclude duplicate and non-relevant texts, 15 articles were selected. The findings show that EDH is often a complex lesion, associated with other intracranial injuries in 71% of cases, with a predominance of temporal location (58%). Computed tomography is essential for diagnosis, with a volume ≥30 cm³ being the main anatomical criterion for surgical indication. Despite presenting lower mortality (7.2%) among extra-axial hematomas, EDH is associated with worse long-term functional outcomes, even in mild TBI. Early surgical intervention significantly reduces mortality, including in elderly patients. It is concluded that traumatic EDH is an emergency whose management is based on clinical and radiological criteria, especially a volume ≥30 cm³. Early recognition and intervention are essential to reduce mortality and improve clinical outcomes.