Sequential CT scan assessment of delayed epidural hematoma in head trauma without neurological deficit

We report four cases of delayed epidural hematoma in head trauma patients without neurological deficit on admission and with a negative or minimally abnormal initial cranial CT scan. In all patients the control CT scan was performed within 12 hours after trauma and it revealed the presence of a delayed epidural hematoma that was surgically removed. On the basis of relevant literature, the modalities of monitoring the clinical and neurological examination and times of sequential control CT scan planning are discussed. Even a strict observation of pertinent guidelines on the topic may not be enough for the prompt diagnosis of enlarging epidural hematoma and allow craniotomy surgery to avoid the fatal outcome which occurred in two patients of our series.