Anterior temporal extradural hematoma

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 hematoma measuring 12mm in depth. This exerts a minimal mass effect on the temporal pole. No new intracranial hemorrhage. 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 hematoma. Minimal mass effect on the adjacent temporal lobe. No new intracranial hemorrhage or evidence of acute ischemia. Ventricles within normal limits. Right orbital / facial bone fractures are unchanged​.

Case Discussion

This case illustrates a benign form of extradural hemorrhage that may happen in the context of trauma and usually not requires surgical intervention. The anterior temporal extradural hematomas 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 hemorrhages. 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
Published: 4th Jun 2016
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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