Treatment Options for Intracranial Epidural Hematoma - An Integrative Review of the Past Three Decades

Abstract Introduction Acute epidural intracranial hematoma (IEH) has been considered one of the most relevant neurosurgical emergencies in recent decades due to its high potential for morbidity and mortality. Early diagnosis followed by appropriate treatment results in a more favorable prognosis considering its rapid progression. Objective To describe the various treatment modalities for IEH in the last three decades and their updates. Methods Integrative literature review on therapeutic options in IEH treatment. The terms “Epidural hematoma,” “Traumatic brain injury,” and “treatment” were used in the Medline/PubMed, Google Scholar, and SciELO platforms, resulting in 90 articles. Results Appropriate treatment for IEH depends directly on the Glasgow Coma Scale score obtained during admission, bleeding location, lesion size, presence of associated intracranial injuries, and the neurosurgeon's experience. Conclusion Initial treatment for IEH is predominantly surgical, with conservative treatment indicated in selected cases. Both neurosurgeons and clinicians must identify characteristic signs and symptoms promptly to avoid treatment delay. Moreover, minimally invasive approaches have gained prominence in recent decades, associated with image-guided procedures, and when well-indicated, result in rapid recovery and lower morbidity.