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Epidural haematoma — MCCQE Part 1 MCQ

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ModerateTraumaEpidural haematomaMCCQE Part 1

A 22-year-old man after a fight has a GCS 13 (E3V4M6). Brief LOC at scene. Now oriented with headache. CT: right temporal epidural haematoma, 8mm midline shift. Most appropriate management?

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Correct answer: A — Emergent surgical evacuation (craniotomy)

Epidural haematoma >15mm thickness or >5mm midline shift or GCS <15 = emergent surgical evacuation. Classic lucid interval may precede rapid deterioration from temporal lobe herniation.

Reference: Canadian Neurosurgery / ATLS