An 19-year-old man is admitted to the emergency room following a motorcycle accident. He is ale and fully oriented, but witnesses to the accident repo an interval of unresponsiveness following the injury. Skull films show a fracture of the left temporal bone. Following x-ray, the patient suddenly loses consciousness and dilation of the left pupil is noted. This patient should be considered to have?
Epidural hematomas are typically caused by a tear of the middle meningeal aery or vein or a dural venous sinus. Ninety percent of epidural hematomas are associated with linear skull fractures, usually in the temporal region. The lesion appears as a hyperdense biconvex mass between the skull and brain on CT scan. The typical history is one of head trauma followed by a momentary alteration in consciousness and then a lucid interval lasting for up to a few hours. This is followed by a loss of consciousness, dilation of the pupil on the side of the epidural hematoma, and then compromise of the brainstem and death.
Ruptured berry aneurysm
Epidural hematoma
Acute subdural hematoma
Intra Abdominal hemorrhage