Symptoms:

A health care provider should be consulted for any head injury that results in even a brief loss of consciousness or if there are any other symptoms after a head injury (even without loss of consciousness).

The typical pattern of symptoms that indicate an extradural hemorrhage is loss of consciousness, followed by alertness, then loss of consciousness again. But this pattern may NOT appear in all people.

The most important symptoms of an extradural hemorrhage are:

• Confusion
• Dizziness
• Drowsiness or altered level of alertness
• Enlarged pupil in one eye
• Headache (severe)
• Head injury or trauma followed by loss of consciousness, a period of alertness, then rapid deterioration back to unconsciousness
• Nausea and/or vomiting
• Weakness of part of the body, usually on the opposite side from the side with the enlarged pupil

The symptoms usually occur within minutes to hours after a head injury and indicate an emergency situation.

Signs and tests:

The neurological 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.

If there is increased intracranial pressure, emergency surgery may be needed in order to relieve the pressure and prevent further brain injury.

A head CT scan will confirm the diagnosis of an extradural hemorrhage and will pinpoint the exact location of the hematoma and any associated skull fracture.