| Print Date: | June 20, 2013, 12:23 pm |
| Title | 1. Acute anterior and subtemporal epidural hematoma. 2. Subtle linear skull fracture. |
| Text | Did I hear someone say "unfair, the skull fracture is too subtle to call"? Perhaps you are correct, but the diagnosis should still be made, whether or not a fracture is present. Although skull fractures are present in the vast majority of EDHs, 5-15% will not have a visible fracture. EDHs without fractures are especially common in children because of the greater elasticity of the pediatric skull. The greater flexibility of the skull in children allows sufficient inbending and plastic distortion to produce meningeal artery injury without necessarily causing a fracture.
It is becoming increasingly common for neurosurgeons to manage neurologically intact patients with small EDHs (< 40 ml) nonoperatively. It is imperative to carefully observe these patients since as many as 9% of EDHs will show significant enlargement subsequent to the initial CT scan. Temporal EDHs, because of their close proximity to the brain stem, are particularly hazardous to manage nonoperatively. Slight changes in the size of these lesions may result in temporal lobe herniation and secondary brain stem injury. ============================================== Epidural hematomas are also called "extradural" or "subperiosteal". |
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| Contributor | Neuroradiology Learning File - © ACR (ACR Learning File®) |
| Author | Lindell R. Gentry, MD |
| Peer Reviewer | James G. Smirniotopoulos, M.D. (Uniformed Services University) |
| Record Number | : 1534 |
| Created | 2001-03-27 10:57:27-05 |
| Modified | 2004-04-25 00:00:11-04 |
| Category: | Trauma |
| Location: | Brain and Neuro |
| Sublocation: | None Selected |
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