What is the expected diagnosis for a patient who loses consciousness after a head injury?

What is the expected diagnosis for a patient who loses consciousness after a head injury?

• A. Subdural hematoma
• B. Epidural hematoma
• C. Intracerebral hemorrhage
• D. Skull fracture

Answer: (B)

When head trauma is followed by loss of consciousness, think of an epidural hematoma because arterial bleeding can rapidly raise pressure inside the skull. This usually occurs when the middle meningeal artery is torn, often with a temporal bone fracture, and it creates a fast-expanding bleed between the dura and the skull. The rapid accumulation leads to quick neurologic decline if not treated. A classic pattern is a brief loss of consciousness at the moment of injury, a period of seeming recovery (lucid interval), then sudden deterioration as the hematoma enlarges. This makes it the most likely diagnosis in an acute setting after head trauma with loss of consciousness. Subdural hematoma involves venous bleeding and tends to have slower, more progressive symptoms; intracerebral hemorrhage presents with brain tissue bleeding and often focal deficits; skull fracture is a bone injury and doesn’t by itself explain the rapid neurologic collapse.

When head trauma is followed by loss of consciousness, think of an epidural hematoma because arterial bleeding can rapidly raise pressure inside the skull. This usually occurs when the middle meningeal artery is torn, often with a temporal bone fracture, and it creates a fast-expanding bleed between the dura and the skull. The rapid accumulation leads to quick neurologic decline if not treated. A classic pattern is a brief loss of consciousness at the moment of injury, a period of seeming recovery (lucid interval), then sudden deterioration as the hematoma enlarges. This makes it the most likely diagnosis in an acute setting after head trauma with loss of consciousness. Subdural hematoma involves venous bleeding and tends to have slower, more progressive symptoms; intracerebral hemorrhage presents with brain tissue bleeding and often focal deficits; skull fracture is a bone injury and doesn’t by itself explain the rapid neurologic collapse.