Intracranial haemorrhage Extradural haemorrhage

Usually presents acutely after head injury. Characterised by falling Glasgow Coma Score progressing to coma, focal signs (lateralising weakness or anaesthesia, pupillary signs), visual disturbances and seizures. Treatment by random burr holes has been supplanted by directed drainage following CT scan localisation.

A conservative approach may be adopted for small haematomata but increasing size (assessed by regular CT scanning or clinical deterioration) are indications for surgical drainage.

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