Extradural hematoma
Key points
- An extradural hemorrhage is caused by bleeding between the inner skull wall and the outer membrane covering the brain, called the "dura mater" or "dura."
- An extradural hemorrhage is often caused by a skull fracture during childhood or adolescence.
- The health care provider should be consulted for any head injury that results in even a brief loss of consciousness or if other symptoms are present after head injury (even without loss of consciousness).
- The neurologic examination may indicate that a specific part of the brain is malfunctioning (for instance, arm weakness on one side) or may indicate increased intracranial pressure.
Alternative names
Extradural hemorrhage; Epidural hematoma
Definition
An extradural hemorrhage is caused by bleeding between the inner skull wall and the outer membrane covering the brain, called the "dura mater" or "dura."
Causes, incidence, and risk factors
An extradural hemorrhage is often caused by a skull fracture during childhood or adolescence. This type of bleeding is more common in young people because the membrane covering the brain is not as firmly attached to the skull as it is in older people.
An extradural hemorrhage occurs when there is a rupture of a blood vessel, usually an artery, which then bleeds into the space between the "dura mater" and the skull. The affected vessels are often torn by skull fractures.
This is most often the result of a severe head injury, such as those caused by motorcycle or automobile accidents. Extradural hemorrhages can be caused by venous bleeding in young children.
Rapid bleeding causes a collection of blood (hematoma) that presses on the brain, causing a rapid increase of the pressure inside the head (intracranial pressure), which may result in additional brain injury.
An extradural hemorrhage is an emergency because it may lead to permanent brain damage and death if left untreated. There may be a rapid worsening within minutes to hours, from drowsiness to coma and death.
Symptoms
The health care provider should be consulted for any head injury that results in even a brief loss of consciousness or if other symptoms are present after head injury (even without loss of consciousness).
The typical symptom pattern of loss of consciousness, followed by alertness, then loss of consciousness again may not appear in all people, but strongly indicates an extradural hemorrhage.
The most important symptoms of an extradural hemorrhage are:
- Headache, severe
- Drowsiness
- Confusion
- Nausea or vomiting may accompany the headache
- Dizziness
- Enlarged pupil in one eye
- Weakness of part of the body, usually on the opposite side from the side with the enlarged pupil
- Head injury or trauma followed by loss of consciousness, an alert period of time, then rapid deterioration back to unconsciousness
The symptoms usually occur within minutes to hours after a head injury and indicate an emergency situation.
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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