On the inner surface of the skull equivalent to the solar plexus, there is a middle dural artery passing through. When the head is injured, especially after a violent blow to the temple, the middle dural artery and its branches can easily rupture and bleed, forming an epidural hematoma. If resuscitation is not timely, it can endanger life or cause disability. Why is an epidural hematoma so dangerous? “As we know, the brain is the “headquarters” of the human body and “resides” in the cranial cavity composed of the skull. Under normal circumstances, the volume of the cranial cavity is 8% to 10% larger than the volume of the brain, and there is a certain gap between the brain and the cranial cavity, so that the soft brain tissue, like tofu, is not pressurized, keeping the “command” work can be carried out normally. When an epidural hematoma occurs, the cranial cavity is increased by the “uninvited guest” of the hematoma, and the hard skull does not stretch. When the difference between the volume of the cranial cavity and the volume of the brain is less than 8%, which corresponds to a hematoma of about 10 ml, an increase in intracranial pressure can occur. After the increase of intracranial pressure, the capillary and venous blood return of the brain is blocked, blood is stagnated in the veins, and cerebral edema occurs in brain tissue due to lack of oxygen. At the same time, cerebrospinal fluid circulation pathway is also obstructed, resulting in cerebrospinal fluid stagnation in the cranium, causing acute hydrocephalus. Cerebral edema and hydrocephalus increase the volume of the brain, which further increases the intracranial pressure. As a result of turtling, the hematoma as the center of pressure forces the brain tissue to migrate to the gaps and orifices with lower pressure, forming brain herniation and compressing the respiratory and heartbeat centers, the patient dies due to respiratory and heartbeat arrest. Herniation The typical presentation of an epidural hematoma is a coma that occurs after the injury and gradually wakes up within minutes or hours. As the hematoma grows, the patient falls back into a comatose state. This intermediate period of wakefulness can be quite confusing, and the patient’s family often thinks it is a sign of improvement and relaxes their vigilance, waiting until they are in a coma again before sending them to the hospital for rescue, which may cause irreparable damage. The epidural hematoma not only hides in the middle waking period, some patients also have brain injury too heavy or bleeding too fast, not yet through the initial coma, then into the late coma, and there is no middle waking period, it is easy to delay the diagnosis and treatment. Other patients with mild traumatic brain injury have a short coma time, which is also easy to overlook. Postictal epidural hematoma can be divided into three categories according to the speed of progression: acute hematoma with symptoms within 3 days; subacute hematoma with symptoms within 3 days to 2 weeks after injury; and chronic hematoma with symptoms more than 2 weeks after injury. This posterior subacute and chronic hematoma is due to the relatively mild traumatic brain injury, where only slow bleeding from small intracranial veins occurs. Patients with subacute hematomas can recover after treatment, but the recovery is slow; in patients with chronic hematomas, complete recovery may occur with a quiescent phase. When the hematoma increases to a certain extent, the signs of increased intracranial pressure and brain compression appear again. Therefore, the recovery period of subacute hematoma and the resting phase of chronic hematoma are easily neglected, resulting in serious consequences. Therefore, we should be vigilant to patients with head injury, regardless of the severity of the injury, and should go to the hospital in a timely manner, and the diagnosis can be clearly made by X-ray head radiography and CT examination in general. Patients should be operated in time to remove the hematoma.