Critical Care Registered Nurse (CCRN) Practice Exam

Which type of hematoma is considered a surgical emergency?

1. Chronic subdural hematoma

2. Acute subdural hematoma

3. Chronic epidural hematoma

4. Acute epidural hematoma

The correct answer is: Acute epidural hematoma

An acute epidural hematoma is considered a surgical emergency primarily because of the potential for rapid deterioration in the patient's neurological status. This type of hematoma typically occurs following a traumatic head injury where blood collects between the dura mater and the skull. As this hematoma grows, it increases intracranial pressure, which can lead to herniation of brain tissues, loss of consciousness, and death if not treated promptly. The classic presentation often includes a brief loss of consciousness followed by a lucid interval, during which the patient appears stable before rapid decline. Immediate surgical intervention is often required to evacuate the hematoma, relieve pressure, and restore cerebral function, making it critical that healthcare providers recognize the urgency of this condition. The other types of hematomas, such as chronic subdural and chronic epidural hematomas, tend to develop more insidiously and are often managed less acutely, thereby not classified as emergencies. An acute subdural hematoma could also be serious but is generally considered less urgent than an acute epidural hematoma.