Extradural hematomaWhat is the diagnosis?

Quiz mode

CT 1 / 1

Axial non-contrast CT of the head (arrow from the original source).

Image: James Heilman, MD, CC BY-SA 4.0 — source

Answer hidden. Review the images and history, decide on your diagnosis, then reveal.

Findings

Biconvex (lentiform) hyperdense extra-axial collection over the left hemisphere (arrow)
Mass effect with effacement of the adjacent sulci
Additional hyperdense foci in the brain parenchyma, consistent with contusions

Case discussion

A lens-shaped collection that does not cross suture lines is an extradural hematoma, usually from a tear of the middle meningeal artery associated with a temporal bone fracture. Check bone windows for the fracture.

Deterioration can be rapid. Large hematomas or neurological decline need urgent neurosurgical evacuation; outcomes are often good when this happens quickly.

Encyclopedia

Extradural hematomaArterial bleeding between the skull and the dura, typically after a temporal bone fracture, forming a biconvex collection that does not cross sutures.

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