Extradural HAEMORRHAGE (i-learn) CNS System

Extradural Hamemorrage

1. EXTRADURAL HAEMORRHAGE FARHAN BINTI MOHD NOR 2018402644 HS2423C

2. DEFINITION A type of Traumatic Brain Injury(TBI) (Kowalczyk,2017) The bleeding into the space between the skull and dura mater often from the middle meningeal artery injury. (Greenwood,2016) Synonym : Epidural Haemorrhage / haematoma (Ferri,2019) Relatively uncommon (less than 1% of all patients with head injuries and less than 10% of those who are comatose ) (Maugeri et al ,2015)

3. SITE OF HAEMORRHAGE -Between skull and duramater - (Rawat,2015) ( Bailey,2016)

4. ETIOLOGY ( Ferri , 2019)

5. SIGN AND SYMPTOM (Ferri,2019)

6. PATHOPHYSIOLOGY (Knott, 2016)

7. IMAGING MODALITIES

8. IMAGE APPEARANCES

9. CT Scan (Lolli, Pezzullo , Delpierre et al,2016) Non-enhanced CT demonstrates a large temporoparietal biconvex epidural haematoma , with low-density areas suggesting active bleeding (swirl sign) (arrow). Calvarium Frontal Lobe Dura mater Aneterior Horn of lareral Ventricle Occipital Horn of lateral ventricle Midline Shift

10. MRI (Ferri,2019) Coronal T2-weighted images show hypointense biconvex (Arrow) extraaxial collection in the left temporal region Frontal lobe Temporal region Dura Mater Biconvex extraaxial collection

11. Technical consideration A narrow window width (80–100 HU) is used to view the brain W hereas a slightly wider window (150–200 HU) is recommended to increase contrast between extra-axial collections and the adjacent skull. M ultiplanar reformation(MPR) is recommended to better evaluate fracture lines and orientation of displaced fragments, especially in patients with complex facial and temporal bone fractures. ( Mutch et al 2016) In CT scan, non-contrast examination is carried out to prevent visualization of blood being obscured by contrast media . ( Holmes,2017).

12. COMPLICATION Herniation of the brain and permanent coma Normal pressure hydrocephalus , which can lead to weakness, headaches, incontinence, and difficulty walking Paralysis or loss of sensation (which began at the time of the injury) There is a risk of permanent brain injury, even if EDH is treated. Symptoms (such as seizures ) may persist for several months, even after treatment. ( Stippler , 2016)

13. REFERENCES Ferri F. F.(2019). Ferri’s Clinical Advisor. 21 st ed. Elsevier. Pp: 515. Revised on 10/10/2018. Greenwood M.(2016). Essential of Human Disease In Dentistry . 2 nd ed. WILEY Blackwell, pp.148. Revised on 5/10/18 . Heit J.J, Iv M. and Wintermark M.(2017). Imaging of Intracranial Hemorrhage. Retrieved from https:// www.j-stroke.org/journal/view.php?doi=10.5853/jos.2016.00563 on 9/10/2018 Kowalczyk N.(2017). Just the Facts 101 . 1 st ed. Content Technologies Inc., pp.256. Revised on 5/10/18. Knott L.(2016). Extradural Hematoma . Retrieved from https://patient.info/health/extradural-haematoma-leaflet on 9/10/2018 Lolli V., Pezzullo M. , Delpierre I. and Sadeghi N..(2016). MDCT Imaging of Traumatic Brain Injury. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985461/ on 9/10/2018 McDonald , D.K. (2015). Imaging in Epidural Hematoma . Retrieved from https:// emedicine.medscape.com/article/340527-overview#a5 on 9/10/2018 Mutch A.C, Talbott F.J. and Gean Alisa.(2016). Imaging Evaluation of Acute Traumatic Brain Injury . Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027071/ on 9/10/2018 Stippler , M. Craniocerebral trauma . (2016) In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice . 7th ed. Philadelphia, PA: Elsevier. Revised on 4/10/18