ABSTRACT
Microscopy Few cells Neutrophils Lymphocytes Lymphocytes Glucose 50-66% blood
level Low Normal Low
Appearance Clear Purulent Turbid Turbid
14. e.e scenario describes how a classical extradural haematoma presents with devastating consequences. Classically, the pterion (region of the skull formed by the sutures of the frontal, parietal, temporal and sphenoid bones) is fractured resulting in rupture of the middle meningeal artery. e force of the injury knocks the patient unconscious for a few minutes and is followed by a ‘lucid interval’ before a further deterioration in consciousness. e arterial blood rapidly collects in the extradural space creating a lens-shaped defect due to the attachments of the dura to the cranium. Pressure autoregulation by the brain provides compensation until the expanding haematoma causes a rise in intracranial pressure, deterioration in conscious and subsequent death by ‘coning’.
