Epidural hematoma develops between the normally non-existent space between bone and dura. It develops when a fracture of the vault of skull, usually the temporal bone, transects a blood vessels of the dura, usually a branch of the middle meningeal artery. It is always coup and never contre coup. Classically, it develops only several hours after trauma, as the blood flow through the middle meningeal artery is small. Because of that, patients usually are fully conscious in the beginning right after trauma, i.e. have a lucid interval, and then lapse into coma.

Epidural hematoma classically occurs in young people in the scenario described. It is a neurosurgical emergency. In general, no patient should be allowed to die from an isolated epidural hematoma.