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Risk factor for intracranial haematoma

• Most significant risk factors are
  • Reduced level of consciousness
  • Presence of a skull fracture

GCS	Risk	Other features	Risk
15	1 : 3,615	None	1: 31,300
		Post-traumatic amnesia	1: 6,700
		Skull fracture	1: 81
		Skull fracture + PTA	1: 29
9-14	1:51	No fracture	1: 180
		Skull fracture	1: 5
3-8	1:7	No fracture	1: 27
		Skull fracture	1: 4

Extradural haematoma

• Complication of low velocity injuries
• Classic presentation
  • Transient loss of consciousness with rapid recovery
  • Lucid interval
  • Rapid deterioration in level of consciousness
  • Increased blood pressure. Falling pulse rate
  • Contralateral limb weakness
  • Ipsilateral pupillary dilatation

• Treatment
  • Emergency burr hole

Subdural haematoma

• Complication of high velocity injury
• Patient usually unconscious from the time of injury
• Deteriorating level of consciousness

• Treatment
  • Decompressive craniotomy

Position of emergency burr holes

Bibliography

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