Epidural/Subdural Hematoma

Question 1

Epidural hematomas are highly unlikely following blunt trauma in those under age __ and over age __

Answer 1

Epidural hematomas are highly unlikely following blunt trauma in those under age 2 and over age 60

This is because in those younger than age 2 the calvarium is extremely pliable, and in those older than age 60 the dura is strongly adhered to the inner table of the skull

Question 2

Spinal epidural hematoma

Answer 2

• When there is an epidural hematoma in the spinal canal
• Presents as:
  
  • Severe localized back pain following blunt injury
  • Progression to radiating back pain mimicing the radicular pain of disc herniation

Question 3

Decerebrate vs decorticate posturing

Answer 3

Question 4

Presence of air in an epidural hematoma

Answer 4

Suggests fracture of the sinuses or mastoid air cells

Question 5

Positioning to reduce ICP

Answer 5

In bed: Elevation of head of bed by 30 degrees

In OR: Reverse Trendelenburg to 30 degrees

Question 6

Best predictor of how someone will do in surgery following EDH

Answer 6

Status of awareness / GCS prior to the procedure

If the pupils are appropriately reactive just prior to surgery, the prognosis is excellent