Depressed skull fracture with extradural hematoma

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Hit in face by flying object.

Patient Data

Age: 25 years
Gender: Male

Depressed left skull fracture (up to 4 mm) of the squamous left temporal bone and diastasis of the squamous suture and inferior extension into the greater wing of sphenoid. Left anterior cranial floor/orbital roof fracture. Left superolateral orbital rim fracture with mild diastasis of the left zygomaticofrontal suture. No extension into the petrous temporal bone.

Left frontal and temporal extradural hematoma. Left frontal parenchymal contusion. Petechial hemorrhages in the left temporal lobe. Tiny locule of pneumocephalus. Rightward midline shift. No uncal or subfalcine herniation. No hydrocephalus. 

Case Discussion

Typical appearances of extradural hematoma and depressed skull fracture. The patient required urgent neurosurgery, undergoing craniectomy, clot evacuation, and cranioplasty. 

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