Neuro: Extradural Hematoma: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Extradural Haematoma (EDH)🎧 A rapid, high-yield breakdown of this neurosurgical emergency — ideal for exam prep and acute clinical scenarios.🧠 Key Learning Points📌 Definition• Extradural haematoma (EDH), also called epidural haematoma, is a collection of blood between the skull and dura mater• Most often caused by trauma, typically from a temporal bone fracture• Usually due to rupture of the middle meningeal artery💡 Mnemonic: "Lucid, then lose it" – classic for EDH📌 Causes & Risk Factors• Head trauma (most common) – e.g. RTA, fall, assault• Middle meningeal artery rupture (classic), but can be from venous sinuses or contralateral surgery• Risk Factors:– Contact sports– Alcohol misuse– Skull fracture history– Anticoagulant use– Age 20–40, M:F ratio 4:1📌 Pathophysiology• Arterial bleed rapidly increases intracranial pressure (ICP)• Blood collects in tight extradural space → compression of brain → herniation risk• Classic CT: biconvex/lens-shaped (lemon-shaped) haematoma📌 Symptoms• Initial LOC → lucid interval → rapid decline• Severe headache, vomiting, confusion, seizures• Focal neurology (e.g. pupil dilation, hemiparesis)• Seizures, unequal pupils, brisk reflexes⚠️ Don’t rely on lucid interval – not always present📌 Differential Diagnosis• Subdural haematoma (crescent shape, venous, slower)• Intracerebral haemorrhage• Brain tumour• Abscess• Post-concussion syndrome• Alcohol or drug intoxication• Stroke or TIA📌 Investigations• Urgent non-contrast CT head – gold standard• Look for biconvex haematoma, skull fracture, mass effect• Avoid lumbar puncture – risk of herniation• Bloods: FBC, U&E• Cervical spine CT if trauma• Repeat CT if deterioration📌 Management• ABC resuscitation first• Urgent neurosurgical referral• Definitive: craniotomy or burr holes to evacuate clot• ICP control:– IV mannitol or hypertonic saline– Elevate head of bed– Controlled hyperventilation (short term)• DVT prophylaxis (low-dose heparin), PPI for GI protection• Conservative management only in small, stable EDH with close monitoring📌 Prognosis• Excellent if diagnosed and treated early• Poorer if: GCS < 8, dilated pupil, decerebrate posturing• Mortality ≈ 30%, but much better if alert on admission• Worse in age >75• Risks of seizures, cognitive impairment, long-term deficits if delayed treatment📌 Complications• Brain herniation• Long-term neuro deficits• Post-traumatic seizures (esp. in alcoholics)• Post-concussion syndrome• Spinal EDH: weakness, incontinence, neuropathic pain📎 More MSRA Resources for Extradural Haematoma📝 Revision Notes: https://www.passthemsra.com/topic/extradural-haematoma-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/extradural-haematoma-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/extradural-haematoma-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/extradural-haematoma-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/neurology-for-the-msra/Hashtags#MSRA #MSRARevision #MSRANeurology #MSRAFlashcards #MSRAQuestionBank #MSRAQuiz #MSRATextbook #ExtraduralHaematoma #EDH #LucidInterval #NeurosurgicalEmergency #PassTheMSRA #FreeMSRA