Neuroimaging Cases 004

Epidural hematomas

Latest instalment in our neuroimaging series. Images, text and cases collated by Madison Watts MD, Faith Meyers MD and Steven Perry MD. First published on EMGuideWire.com and peer reviewed by Professor Michael Gibbs.

Cases reviewed

• Case 1: 21-year-old female brought into the ED after she fell out of an open-door Jeep traveling at approximately 10 miles per hour.
• Case 2: 15-year-old male brought into the ED by his parents after he sustained an un-helmeted fall off of his skateboard.
• Case 3: 48-year-old male found in his garage after a fall off a ladder from an unknown height onto the concrete floor.

References

• Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, Servadei F, Walters BC, Wilberger JE; Surgical Management of Traumatic Brain Injury Author Group. Surgical management of acute epidural hematomas. Neurosurgery. 2006 Mar;58(3 Suppl):S7-15
• Lee EJ, Hung YC, Wang LC, Chung KC, Chen HH. Factors influencing the functional outcome of patients with acute epidural hematomas: analysis of 200 patients undergoing surgery. J Trauma. 1998 Nov;45(5):946-52
• Rivas JJ, Lobato RD, Sarabia R, Cordobés F, Cabrera A, Gomez P. Extradural hematoma: analysis of factors influencing the courses of 161 patients. Neurosurgery. 1988 Jul;23(1):44-51.
• Beniwal HK, Reddy MS, Rao GP, Srikrishnaditya M, Beniwal A. Prognostic Value of Swirl Sign in Acute Epidural Hemorrhage. Asian J Neurosurg. 2022 Nov 15;17(4):584-587.
• Gok H, Celik SE, Yangi K, Yavuz AY, Percinoglu G, Unlu NU, Goksu K. Management of Epidural Hematomas in Pediatric and Adult Population: A Hospital-Based Retrospective Study. World Neurosurg. 2023 Jul
• Maugeri R, Anderson DG, Graziano F, Meccio F, Visocchi M, Iacopino DG. Conservative vs. Surgical Management of Post-Traumatic Epidural Hematoma: A Case and Review of Literature. Am J Case Rep. 2015 Nov 14;16:811-7.
• Gutowski P, Meier U, Rohde V, Lemcke J, von der Brelie C. Clinical Outcome of Epidural Hematoma Treated Surgically in the Era of Modern Resuscitation and Trauma Care. World Neurosurg. 2018 Oct

This neuroimaging interpretation series is proudly sponsored by the Emergency Medicine Residency Program at Carolinas Medical Center. The goal is to promote widespread mastery of CXR interpretation. There is no personal health information [PHI] within, and ages have been changed to protect patient confidentiality.