EXTRADURAL HEMORRHAGE

General Information

DEFINITION--Bleeding between the skull and the outermost of 3 membranes that cover the brain (meninges). May be confused with meningitis. A hematoma (collection of clotted blood) forms and rapidly enlarges, increasing pressure within the skull and causing symptoms.

BODY PARTS INVOLVED--Skull; meninges; brain.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS--

These symptoms develop within 24 to 96 hours after a head injury:

• Headache that steadily worsens.
• Drowsiness or unconsciousness.
• Nausea or vomiting.
• Inability to move arms and legs.
• Change in the size of eye pupils.

CAUSES--Head injury.

RISK INCREASES WITH

• Use of anticoagulant drugs.
• Bleeding disorders, such as hemophilia, ITT or aplastic anemia.
• Injuries. These occur more often after excess alcohol consumption or use of mind-altering drugs.

HOW TO PREVENT--

Avoid head injury in the following ways:

• Use seat belts in cars.
• Wear protective head gear during contact sports or while riding a bicycle or motorcycle.
• Don't drink alcohol or use mind-altering drugs and drive.
• Seek medical advice for even a moderate blow to the head.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies of blood and cerebrospinal fluid.
• Hospital diagnostic tests, such as x-rays of the head, arteriography, radioscopic scan and CT scan (See Glossary for all).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Extradural hemorrhage is an emergency that requires rapid treatment to prevent permanent brain damage or death. Surgical treatment consists of drilling a hole in the skull, draining the blood clot and clipping the ruptured blood vessel.
• Home-care after surgery.

POSSIBLE COMPLICATIONS--Fatal compression of the brain if bleeding lasts longer than 24 hours.

PROBABLE OUTCOME--Quick diagnosis and prompt surgery usually bring complete recovery.

How To Treat

GENERAL MEASURES--

• The family should maintain an optimistic outlook, stay in close contact with the patient's doctor and help by making their visits with the patient brief and as supportive as possible.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe cortisone drugs to reduce swelling inside the skull.

ACTIVITY--Stay as active as your strength allows. Work and exercise moderately. Rest when you tire. If speech or muscle control has been damaged, you may need physical therapy or speech therapy.

DIET--Eat a normal, well-balanced diet. Vitamin and mineral supplements should not be necessary unless you cannot eat normally.

Call Your Doctor If

• You have had a head injury--even if it seems minor--and you develop any symptoms of extradural hemorrhage.
• The following occurs during treatment: Fever. Surgical wound becomes red, swollen or tender. Headache worsens.