Extradural haemorrhage

Question 1

Define

Answer 1

Bleeding and accumulation of blood in the extradural haemorrhage

Question 2

What are the risk factors?

Answer 2

Trauma - middle meningeal artery

Bleeding tendency

Question 3

Epidemiology

Answer 3

• UK incidence: 20/10,000
• 10% of severe head injuries
• Most commonly seen in YOUNG ADULTS

Question 4

What are the presenting symptoms?

Answer 4

• Head injury with temporary loss of consciousness
• Followed by lucid interval
• Followed by progressive deterioration in conscious level

Question 5

What are the signs?

Answer 5

•	Scalp trauma or fracture 
•	Headache 
•	Deteriorating GCS 
•	Signs of raised ICP 
o	E.g. dilated, unresponsive pupil on the side of the injury 
•	Cushing's Reflex
o	Hypertension 
o	Bradycardia 
o	Irregular breathing

Question 6

What are the appropriate investigations?

Answer 6

• Urgent CT Scan

o Check for a haematoma
o Look for features of raised ICP (e.g. midline shift)