Extradural hematoma; Epidural hematoma
An extradural hemorrhage is bleeding between the inside of the skull and the outer covering of the brain (called the "dura").
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 (from a vein) 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). This pressure 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.
Biros MH, Heegaard WG. Head injury. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 38.
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