Hypodense area within epidural hematoma in brain CT scan; Prediction of active bleeding in epidural hematoma

Abstract

Background: One of the most important factors in management of patients with epidural hematoma is the existence of hypodense area within the hematoma (SWIRL sign) in brain CT scan. This finding can be the sign of active bleeding and developing the hematoma. Purpose: Study the value of brain CT scan of the patients with epidural hematoma in order to predict the possibility of expansion of the hematoma because of active bleeding. Method: 49 patients with traumatic epidural hematoma entered the study and divided in to 2 groups. Group A was those with epidural hematoma who had indications for immediate craniotomy such as significant midline shift, large size of hematoma, epidural hematoma due to hydrocephalus and etc, and group B was that small or moderate size of epidural hematomas that were kept under close observation without surgery.