Extradural haemorrhage

Question 1

Define extradural haemorrhage

Answer 1

Bleeding & accumulation of blood in the extradural space

Question 2

Aetiology of extradural haemorrhage

Answer 2

TRAUMA

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

Question 3

Risk factors for extradural haemorrhage

Answer 3

Bleeding tendency (e.g. haemophilia, anticoagulant therapy)

Question 4

Presenting symptoms of extradural haemorrhage

3

Answer 4

Head injury with temporary loss of consciousness

Followed by lucid interval

Followed by progressive deterioration in conscious level

Question 5

Epidemiology of extradural haemorrhage

Answer 5

Most commonly seen in young adults
20/10,000 in UK
10% of severe head injuries

Question 6

Signs on examination of extradural haemorrhage

5

Answer 6

Scalp trauma or fracture
Headache
Deteriorating GCS
Signs of raised ICP
Cushing’s reflex

Question 7

Signs of raised ICP

Answer 7

Dilated, unresponsive pupil on side of injury

Question 8

Cushing’s reflex

Answer 8

Hypertension
Bradycardia
Irregular breathing

Question 9

Investigations for extradural haemorrhage

Answer 9

Urgent CT scan

Check for haematoma
Look for features or raised ICP (midline shift)