Epidural Haemorrhage

Question 1

What is the main cause of an epidural haemorrhage?

Answer 1

Head trauma

- Fractured temporal/parietal bone that severs MMA and vein

Question 2

What is the common pattern following the head trauma in epidural haemorrhage?

Answer 2

• Lucid phase

Followed by rapid fall in conscious level

Question 3

Where does blood accumulate in an epidural?

Answer 3

Between bone and dura

Question 4

What causes the eventual loss of consciousness in EH?

Answer 4

Rising ICP

Question 5

What other symptoms are present with an EH?

Answer 5

Severe headache
Vomiting
Confusion
Fits

Question 6

What are the signs of an EH?

Answer 6

Often UMN lesions so UMN signs

• Hemiparesis
• Hyperreflexia
• Babinski +
• Dilation of pupil in ispilateral eye = very bad sign

Question 7

What is the only real investigation for epidural haemorrhage?

Answer 7

CT Head

Do not LP

Question 8

What is shown on the CT?

Answer 8

Usually a lens shaped haematoma

Kept in by dural attachements to the skull

Question 9

Surgical treatment?

Answer 9

Clot evacuation
- Can cause rapid drop in ICP
Stop bleeding

Question 10

Prognosis?

Answer 10

Good if surgery quick

Bad if there is ipsilateral pupil dilatation