Extradural Haematoma

Question 1

What is this a presentation of?
Deteriorating consciousness after any head injury that initially produced brief loss of consciousness or initial drowsiness post injury. Lucid interval is characteristic. Also sever headache, vomiting, confusion, seizures.

Answer 1

Extradural haematoma (talk-and-die syndrome)

Question 2

What is the cause of an extradural haematoma?

Answer 2

Fractured temporal/parietal bone causing laceration of the middle meningeal artery and vein, typically after trauma to the temple just lateral to the eye.

Question 3

What is the late presentation of an extradural haematoma?

Answer 3

Ipsilateral pupil dilates, coma, death from respiratory depression.

Question 4

What investigations are performed for a suspected extradural haematoma and what would they show?

Answer 4

1. CT shows lens-shaped/biconvex shaped haematoma

2. LP contraindicated

Question 5

What is the management for an extradural haematoma?

Answer 5

Immediate referral to neurosurgery