Treatment of Nontraumatic Epidural Haemorrhage: Acute EDH with Volume <30 cm³, GCS >8, and No Focal Neurological Deficit

This protocol addresses acute epidural hematoma presenting with favourable imaging characteristics and a preserved level of consciousness — a specific subset in which the management approach differs meaningfully from larger or more severe presentations.

All of the following criteria must be met on initial evaluation:

• Hematoma volume less than 30 cm³
• Hematoma thickness less than 15 mm on CT
• Midline shift less than 5 mm on CT
• Glasgow Coma Scale (GCS) score greater than 8
• No focal neurological deficit

In patients meeting these criteria, an epidural hematoma can be managed nonoperatively with serial CT scanning and close neurological observation in a neurosurgical centre.

The protocol incorporates a defined surgical intervention — delayed evacuation of the epidural hematoma — that applies under specific clinical circumstances identifiable during monitoring. The complete conditions, decision criteria, and procedural details are specified in the full protocol.

The full regimen, monitoring parameters, and surgical decision criteria are available via the link below.