Epidural Hematoma (EDH): NEET PG Essentials
1. Pathophysiology
- Mechanism: Usually caused by trauma to the pterion (the weakest part of the skull).
- Vessel: Laceration of the middle meningeal artery (a branch of the maxillary artery).
- Clinical Hallmark: “Lucid interval”—the patient experiences initial loss of consciousness, followed by a period of improved neurological function, then rapid deterioration as intracranial pressure rises.
2. Radiological Findings
| Feature | High-Yield Description |
|---|---|
| Shape | Biconvex (lens-shaped) or lentiform. |
| Suture Lines | Does NOT cross suture lines (because the dura is tightly adhered to the skull at sutures). |
| Contrast | Hyperdense (bright) on non-contrast CT. |
3. Clinical Pearls & Management
- Diagnosis: Non-contrast CT head is the gold standard.
- Management: This is a neurosurgical emergency. Immediate surgical decompression (craniotomy or burr hole evacuation) is required to prevent secondary brain injury from mass effect and herniation.
- Complication: Transtentorial (uncal) herniation, which can manifest as a “blown pupil” (fixed, dilated pupil) on the ipsilateral side of the hematoma due to oculomotor (CN III) nerve compression.
- Free Resources: For further high-yield notes and question banks, visit mymedschool.org.