Extradural Haemorrhage

Question 1

Define Extradural Haemorrhage?

Answer 1

Bleeding and accumulation of blood in the extradural space

Question 2

What is Extradural Haemorrhage usually caused by?

Answer 2

Usually due to fracture of the temporal or parietal bones leading to rupture of the middle meningeal artery

Question 3

What are the risk factors for Extradural Haemorrhage?

Answer 3

Bleeding tendency

E.g. - haemophilia, anticoagulant therapy

Question 4

What is the epidemiology of extradural haemorrhage?

Answer 4

UK incidence: 20/10,000
10% of severe head injuries
Most commonly seen in Young Adults

Question 5

What are the presenting symptoms of extradural haemorrhage?

Answer 5

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

Question 6

What are the signs of extradural haemorrhage on physical examination?

Answer 6

Scalp trauma or fracture
Headache
Deteriorating GCS
Signs of raised ICP
Cushing's Reflex

Question 7

What are the signs of raised ICP?

Answer 7

Dilated, unresponsive pupil on the side of the injury

Question 8

What is Cushing’s Reflex?

Answer 8

Hypertension
Bradycardia
Irregular Breathing

Question 9

What investigations do you do for extradural haemorrhage?

Answer 9

Urgent CT scan
Check for a haematoma
Look for feature of raised ICP (e.g. midline shift)