Anterior temporal extradural haematoma

Case contributed by Dr Bruno Di Muzio

Presentation

Victim of assault, with multiple facial bone fractures.

Patient Data

Age: 35 years
Gender: Male
CT

CT Brain

Right anterior temporal extradural haematoma measuring 12mm in depth. This exerts a minimal mass effect on the temporal pole. No new intracranial haemorrhage. No hydrocephalus.

Right maxillary, orbital, and frontal bone fractures are present (not shown). Right-sided proptosis.

CT

24h later

Comparison is made with CT brain performed yesterday. No significant change in size or morphology of the right anterior temporal extradural haematoma. Minimal mass effect on the adjacent temporal lobe. No new intracranial haemorrhage or evidence of acute ischaemia. Ventricles within normal limits. Right orbital / facial bone fractures are unchanged​.

Case Discussion

This case illustrates a benign form of extradural haemorrhage that may happen in the context of trauma and usually not requires surgical intervention. The anterior temporal extradural haematomas are considered to have a venous source of bleeding (sphene parietal sinus or its major draining veins) instead of the expected arterial origin of the extradural haemorrhages. For this reason, and also for locating anteriorly in the middle cranial fossa, they are associated with a low risk of midline shift, uncal herniation, and brainstem compression.

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Case information

rID: 45674
Case created: 3rd Jun 2016
Last edited: 10th Sep 2017
Inclusion in quiz mode: Included

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