Extradural Haemorrhage

Question 1

Definition

Answer 1

Bleeding and accumulation of blood in the extradural space

Question 2

Aetiology

Answer 2

· TRAUMA

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

Question 3

Risk factors

Answer 3

o Bleeding tendency

· E.g. haemophilia, anticoagulant therapy

Question 4

Epidemiology

Answer 4

· UK incidence: 20/10,000

· 10% of severe head injuries

· Most commonly seen in YOUNG ADULTS

Question 5

Presenting symptoms

Answer 5

· Head injury with temporary loss of consciousness

· Followed by lucid interval

· Followed by progressive deterioration in conscious level

Question 6

Signs on physical examination

Answer 6

· 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 7

Investigations

Answer 7

· Urgent CT Scan

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