Extradural Haematoma Flashcards
What are some causes of EDH?
Traumatic skull fracture, Any tear in a dural venous sinus
Where are common traumatic skull fractures?
Fractured temporal or parietal bone after trauma to the temple just lateral to the eye
How does a traumatic skull fracture cause a bleed?
Leads to laceration of middle meningeal artery and vein
Where does blood accumulate in an EDH?
Between bone and dura
What should you look out for?
A lucid interval
What are the clinical presentations?
Rapidly declining GCS, increasingly severe headache, vomiting, seizures, hemiparesis, UMN signs
What manifestations can appear if bleeding continues?
Ipsilateral pupil dilates, coma deepens, bilateral limb weakness, breathing becomes deep and irregular due to brainstem compression
What are some late signs?
Bradycardia, HTN
What does a EDH look like on a CT?
Biconcave/lens-shaped haematoma, doesn’t cross suture lines
What might a skull x-ray look like?
May show fracture lines crossing the course of the middle meningeal vessels
What investigation is contraindicated in EDH?
Lumbar puncture
What are some differential diagnoses?
Epilepsy, carotid dissection, carbon monoxide poisoning
What is first line management?
Stabilise and transfer urgently to neurosurgical unit
What surgical intervention will be performed?
Clot evacuation +/- ligation of the bleeding vessel
What would you do to care for the airway in an unconscious patient and to help decrease ICP?
Intubation and ventilation, IV mannitol to decrease ICP
