An extradural hematoma is characterized by bleeding between the dura, or outer covering of the brain, and the skull. This type of brain injury is often the result of a skull fracture. Children and adolescents are more prone to developing an extradural hematoma than are adults because the dura is not as firmly attached to the skull in younger patients. An extradural hematoma is a major medical emergency and almost always requires immediate brain surgery in order to save the life of the patient.
There is a typical pattern of events present in patients suffering from an extradural hematoma, but it is important to note that this pattern is not always present. Therefore, any head injury should be considered a medical emergency. A patient with this type of injury will usually lose consciousness for a brief period of time. The patient will then seem alert for a while and then lose consciousness again.
Other potential symptoms suggesting the possibility of an extradural hematoma include nausea and vomiting following a head injury, dizziness, or confusion. It is common for the pupil in one eye to be enlarged while experiencing muscle weakness on the opposite side of the body. These symptoms can develop within minutes or even hours following a head injury.
Medical testing such as a CT scan may be ordered to confirm the skull fracture or the extradural hematoma. This test will show the location and amount of the bleeding as well as any brain swelling that may be present. Emergency surgery generally follows this diagnostic test.
Surgery for an extradural hematoma typically involves drilling a small hole into the skull. This relieves some of the pressure on the brain and allows the surgeon to drain some of the blood that has accumulated inside of the skull. Depending on the extent of the damage, a larger hole may have to be drilled, or a drainage device known as a shunt may have to be implanted. It is not unusual for a patient suffering from this type of injury to be put on life support during and after this type of operation.
An extradural hematoma is a very serious injury, and even with the best medical intervention available, death or disability is a very real possibility. Patients who survive this injury are often left with varying degrees of brain damage, some permanent and sometimes temporary. Complications, such as seizures, can arise months or even years following an injury to this area of the brain.