Extradural haematoma Flashcards
What is an extradural haematoma?
An extradural (or ‘epidural’) haematoma is a collection of blood that is between the skull and the dura.
What typically causes an extradural haematoma?
It is almost always caused by trauma, most typically by ‘low-impact’ trauma (e.g. a blow to the head or a fall).
Where is an extradural haematoma most commonly located?
The collection is often in the temporal region since the thin skull at the pterion overlies the middle meningeal artery.
What is the classical presentation of a patient with an extradural haematoma?
A patient initially loses, briefly regains, and then loses consciousness after a low-impact head injury.
What is the ‘lucid interval’?
The brief regain in consciousness that occurs after the initial loss of consciousness.
What happens as the haematoma expands?
The uncus of the temporal lobe herniates around the tentorium cerebelli, leading to a fixed and dilated pupil.
How does an extradural haematoma appear on imaging?
It appears as a biconvex (or lentiform), hyperdense collection around the surface of the brain.
What limits the extradural haematoma?
They are limited by the suture lines of the skull.
What is the appropriate management for patients with no neurological deficit?
Cautious clinical and radiological observation is appropriate.
What is the definitive treatment for an extradural haematoma?
The definitive treatment is craniotomy and evacuation of the haematoma.
Extradural (epidural) haematoma
Extradural (epidural) haematoma
Extradural (epidural) haematoma
