Extradural Haemorrhage

Collection of blood between the skull and the dura mater

Aetiology

• Typically follows a linear skull vault fracture tearing a branch of the middle meningeal artery

Clinical presentation

• A characteristic picture is that of a head injury with a brief duration of unconsciousness, followed by improvement (lucid interval)

• The patient then becomes stuporose; there is an ipsilateral dilated pupil and contralateral hemiparesis, with rapid transtentorial coning

• Bilateral fixed, dilated pupils, tetraplegia and respiratory arrest follow

Investigations

• Urgent CT brain - described as a lens shaped lesion (biconvex)

Management

• Urgent neurosurgery