Extradural Haemorrhage

Question 1

Define extradural haemorrhage

Answer 1

collection of blood between skull and dura mater

Question 2

What are the causes/risk factors of extradural haemorrhage?

Answer 2

rupture of dural vessels e.g. middle meningeal arteries, veins, dural venous sinuses
• Trauma e.g. assault, fall, accident

Question 3

What are the symptoms of extradural haemorrhage?

Answer 3

• Altered consciousness
• Lucid interval
• Reduced consciousness

Question 4

What are the signs of extradural haemorrhage?

Answer 4

Raised ICP
• Hypertension
• Bradycardia
• Respiratory depression

Question 5

What investigations are carried out for extradural haemorrhage?

Answer 5

• CT - shows a haematoma (often biconvex/lens-shaped; the blood forms a more rounded shape compared with the sickle-shaped subdural haematoma as the tough dural attachments to the skull keep it more localised). Doesn’t cross suture lines; limited anteriorly by the coronal suture and posteriorly by the lambdoid suture
• Skull x-ray - may be normal or show fracture lines crossing the course of the middle meningeal vessels. Lumbar puncture is contraindicated –Risk of herniation