Age/sex: 56-year-old male
Size: 18.5 x 18.0 x 8.0 cm
A collection of blood is present above the dura over the right cerebral hemisphere. The underlying brain is compressed and distorted (the right ventricle (long arrow) is pushed down and reduced to a slit compared with that on the left). There is also herniation of the cingulate gyrus (C) under the falx (short arrow).
Epidural hematoma
This condition usually develops following traumatic injury to the middle meningeal artery. Because of the artery's location, blood accumulates in the space between the skull and the dura causing compression of the underlying brain.
The typical case occurs following a blow to the temporal region just in front of the ear, where the skull bone is relatively thin. Often, the affected individual loses and then regains consciousness for a brief period; without treatment, this can be followed by a second episode of loss of consciousness and death. Because the bleeding is from an artery, this sequence can occur rapidly (over a few hours). When conscious, the patient complains of headache.
The condition is a surgical emergency, requiring drilling of a burr hole over the suspected site of bleeding or a craniotomy to evacuate the blood and relieve pressure on the brain.
Below: The location of the middle meningeal artery in relation to the pterion, the thinnest point on the skull.
Source: Unknown. (2022). Middle meningeal artery embolization for chronic subdural hematoma. Neurosurgery Wiki.
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