Epidural hemorrhage

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Epidemiology

  • Occurs in ~2% of closed head trauma
    • Up to 15% in severe head trauma
  • Predominantly in young males

Etiology

  • Skull fracture in 90%, usually the temporal bone
  • Injury usually to the middle meningeal artery
  • May occur in absence of parenchymal injury

Clinical Presentation

  • Head trauma
  • May present with a lucid interval in about 1/3 of cases
    • Concussion with recovery, lucid period, bleed grows and level of consciousness decreases again

Investigations

  • CT head showing lentiform blood collection

Management

  • Surgical decompression
    • Burr hole or bone flap