followed by a brief loss of consciousness and variable levels of lucidness. this may last for several hours while the brain function deteriorates. if untreated epidural hematoma causes increased blood pressure, shortness of breath, damage to brain function and may result in death. diagnosis in sports subdural and epidural hematomas are serious conditions and should be immediately diagnosed and treated by a physician. hematomas may not show the full extent of the problem initially after the head injury, but it may be revealed after comprehensive medical evaluation and diagnostic test. diagnostic test may include: blood test, x-ray, computed tomography scan (ct/cat scan), electroencephalogram (eeg), and magnetic resonance imaging (mri). the two most important diagnostic tests are the ct scan and the mri. the ct scan reveals evidence of blood within the skull, fractures, and signs of compression on the brain from the hematoma. the mri is a more thorough evaluation of injuries to the brain tissue. yet, an mri cannot take place if the injured patient is in a confused state. small hematomas may not require surgery if there is no pressure on the brain and minimal symptoms. small hematomas may be monitored closely to ensure the hematoma is not enlarging and resolved properly. a large hematoma larger than 1 cm at its thickest point produces severe headaches and brain function deterioration requires immediate surgery by a neurosurgeon. surgery reduces the pressure within the brain and stops the bleeding. prognosis (short/long-term effects) the most crucial aspect for recovery in patients with severe hematomas is rapid diagnosis and appropriate treatment. once the clot has been removed the intracranial pressure is monitored for several days. conditions which are also monitored after surgery are seizures, clot accumulation, and infection. if complications do occur, sometime the hematoma needs to be re-drained. additional complications following a surgical or nonsurgical treatment may include temporary or permanent weakness, numbness, difficulty speaking, memory loss, dizziness, headache, anxiety, difficulty concentrating, seizures, and/or brain herniation. the most helpful predictors of the treatment outcome is the glasgow coma scale (gcs). this is a standardized pupil response assessment of the neurologic status of the patient. gcs helps assess many different types of head injuries and predicts how a patient will recover following a hematoma. factors such as elevated intracranial pressure, increased patients age, and abnormal gcs results lead to a poor prognosis. the mortality rate following a hematoma could be as high as 80% and survivors many not regain the same pre-injury function. subdural and epidural hematomas are serious injuries and recovery varies widely depending on the severity of the hematoma. severity depends on type and location of the injury, the size of the blood collection, and how quickly treatment is obtained. hence, it is difficult to determine when an athlete can return to sports after his/her injury. a variety of multidisciplinary people such as sports medicine physicians, neurologist/neurosurgeons, athletic trainers, coaches, and family require input. if an athlete is approved to return, he or she is required to complete asymptomatic at rest and with exertion. the athlete also has to clear a ct scan indicating the hematoma has entirely resolved. lastly, the athlete needs to be slowly brought back into the sport with close monitoring to be sure the symptoms do not recur. prevention in sports preemptive measures include using safety equipment to reduce your risk of a head injury. equipment examples are hard hats, bicycle or motorcycle helmets, and seat belts. to reduce the risk of hematomas, factors to avoid are taking anticoagulant medication (blood thinners, such as aspirin), long-term abuse of alcohol, repeated falls, and reoccurring head injury.