The aim of this study is to analyze change of annual incidence and causing factors in patients underwent surgical evacuation of an epidural hematoma (EDH) after head injury.

This study comprised 284 patients with EDH who underwent surgery between January 2000 and December 2006. We analyzed retrospectively change of annual incidence, causes and outcome by means of medical records and radiologic study.

The overall incidence of surgical EDH patients among traumatic brain injury patients was 6.7%. The peak incidence of surgical EDH was in the year 2002, and the lowest incidence was in 2006. The causes of EDH were traffic-related accidents, falling from a height, ground-level falls, collisions, assaults, and unknowns, which accounted for 39.1%, 19.4%, 19.7%, 2.8%, 3.5% and 15.5%, respectively. The peak incidence of EDH was in the fifth decade, and the mean age of patients was 37.6 years of age. Glasgow coma scale (GCS) was identified as a significant factor determining outcome at 6 months.

The overall incidence of surgical EDH have decreased, probably because of intensive efforts toward creation and growth of injury prevention programs. But traffic-related accidents have been still main cause, and further reductions will require new research for pedestrian hit by a car.