Extradural Haemorrhage

Question 1

Define

Answer 1

bleeding and accumulation of blood in the extradural space

Question 2

Causes/ Risk factors

Answer 2

TRAUMA

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

Risk Factors

• Bleeding tendency

E.g. haemophilia, anticoagulant therapy

Question 3

Epidemiology

Answer 3

UK incidence: 20/10,000

10% of severe head injuries

Most commonly seen in YOUNG ADULTS

Question 4

Symptoms

Answer 4

Head injury with temporary loss of consciousness

Followed by lucid interval

Followed by progressive deterioration in conscious level

Question 5

Signs

Answer 5

Scalp trauma or fracture

Headache

Deteriorating GCS

Signs of raised ICP

• E.g. dilated, unresponsive pupil on the side of the injury

Cushing’s Reflex

• Hypertension
• Bradycardia
• Irregular breathing

Question 6

Investigations

Answer 6

Urgent CT Scan

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