Anterior temporal extradural haematoma

Case contributed by Dr Bruno Di Muzio

Presentation

Trauma with head strike three days ago.

Patient Data

Age: 42-year-old
Gender: Male
Modality: CT

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.

 

Case Discussion

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.

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Case Information

rID: 45675
Case created: 3rd Jun 2016
Last edited: 5th Jun 2016
Tag: rmh
Inclusion in quiz mode: Excluded

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