The brain is surrounded by three layers of membranes. The outermost, or dura mater, is a tough layer, somewhat thinner than a piece of paper. It separates the brain from the adjacent skull and facial bones. Bleeding can occur in this layer. When it does, it can rapidly accumulate and push on the underlying brain. These types of hemorrhages are most often associated with trauma. They classically have a period after the injury where the person is okay. However, as the hematoma enlarges symptoms may rapidly progress.
Causes of Extradural Hemorrhage
Extradural or epidural hematomas are most frequently caused by trauma. Bleeding from the fractured skull can produce these hematomas. The dura, itself, has blood vessels within in. Laceration of these, usually branches of the middle meningeal artery, can lead to the rapid development of an epidural hematoma. Tumors of the skull or facial bones can lead to bleeding in this space. Occasionally, there can be congenital vascular malformations leading to abnormal blood vessels in the dural that can periodically bleed. .
Signs and Symptoms of Extradural Hemorrhage
The symptoms associated with an extradural or epidural hematoma may occasionally develop rapidly or may evolve over 24 to 96 hours after a head injury. The include new, gradual or rapid onset of headache. Nausea and vomiting may occur as the hematoma enlarged and increases the pressure within the skull. Lethargy and stupor can occur, sometimes associated with changes in the size of one of the pupils. Weakness, numbness or paralysis can occur, usually on one side of the body at first. Sometimes there are visual symptoms or difficulty speaking.
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Medical Content Last Updated on 07/12/2008
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