An epidural hematoma in the athlete most commonly results from a severe blow to the head that typically produces a skull fracture in the temporoparietal region. These are usually isolated injuries involving acceleration/deceleration of the head, with the skull sustaining the major impact forces and absorbing the resultant kinetic energy. The epidural hematoma involves an accumulation of blood between the dura mater and the inner surface of the skull as a result of an arterial bleed, most often from the middle meningeal artery. The hemorrhage results in the classic computed tomography appearance of a biconvex or lenticular shape of the hematoma20 (Fig. 14-1). These are typically fast developing hematomas leading to a deteriorating neurologic status within 10 minutes to 2 hours. The athlete may or may not lose consciousness during this time but will most likely have a lucid interval or altered state of consciousness. The athlete may subsequently appear asymptomatic and have a normal neurologic examination.20 The problem arises when the injury leads to a slow accumulation of blood in the epidural space, causing the athlete to appear asymptomatic until the hematoma reaches a critically large size and begins to compress the underlying
brain.21 Immediate surgery may be required to decompress the hematoma and to control the hemorrhage. The clinical manifestations of epidural hematoma depend on the type and amount of energy transferred, the time course of the hematoma formation, and the presence of simultaneous brain injuries. Often the size of the hematoma determines the clinical effects.22,23
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Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.