Presentation
Trauma with head strike three days ago.
Patient Data
Lateral orbital wall fracture and extraconal lateral orbital wall hematoma (measuring 2mm). Minimal displacement of lateral rectus.
Left anterior temporal extradural hematoma. No other intracranial hemorrhage. No tonsillar or uncal herniation.
Grey-white matter differentiation is preserved with no evidence of acute ischemia. Ventricular size is unchanged. No sellar hemorrhage.
Opacification of the sphenoid sinuses, right mastoid air cells and right middle ear.
Case Discussion
This case illustrates a benign form of extradural hemorrhage that may happen in the context of trauma and usually does not require surgical intervention. The anterior temporal extradural hematomas are considered to have a venous source of bleeding (sphenoparietal sinus or its major draining veins) instead of the expected arterial origin of the extradural hemorrhages. For this reason, and also for locating anteriorly in the middle cranial fossa, they are associated with a low risk of midline shift, uncal herniation, and brainstem compression.
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