Anterior temporal extradural haematoma
Trauma with head strike three days ago.
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Lateral orbital wall fracture and extraconal lateral orbital wall haematoma (measuring 2mm). Minimal displacement of lateral rectus.
Left anterior temporal extradural haematoma. No other intracranial haemorrhage. No tonsillar or uncal herniation.
Grey-white matter differentiation is preserved with no evidence of acute ischaemia. Ventricular size is unchanged. No sellar haemorrhage.
Opacification of the sphenoid sinuses, right mastoid air cells and right middle ear.
This case illustrates a benign form of extradural haemorrhage that may happen in the context of trauma and usually does not require 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.