0:01

Well, in this patient with trauma, we're

0:02

gonna start with the scans of the bone

0:06

windows, and this is the brain scan.

0:10

With the bone windows, we see that the

0:12

patient's had a previous zygomatic arch

0:14

fracture, as well as nasal bone fractures.

0:17

We also see a relatively subtle area where there is a

0:22

fracture of the squamous portion of the temporal bone.

0:26

This is on the

0:28

relatively thick section images.

0:30

We can verify that by looking at the thin

0:34

section images and identifying this area where

0:38

there is a fracture seen on the left side.

0:44

So, in the situation where we see

0:47

a squamous temporal bone fracture,

0:52

we must be concerned about the possibility

0:55

of an epidural hematoma secondary to

0:57

ripping of the middle meningeal artery.

1:00

And, in point of fact, on this axial

1:03

brain image, we see a collection.

1:06

And if I window this a little bit narrower...

1:10

Okay, so now what we see is this collection,

1:15

which is centered at the fracture site.

1:19

This is going down a little bit lower here.

1:23

Centered at the fracture site, it is lenticular.

1:27

It's convex towards the brain rather than

1:31

being crescentic, and this is what one

1:35

would expect of an epidural hematoma.

1:39

I'm just gonna use the magnifying capability here

1:45

to emphasize that this shape is more in keeping with an

1:50

epidural hematoma. So, the fact that it stops at the

1:55

coronal suture, the fact that it is convex outward, lentiform

2:01

in appearance and shape, and is associated with a

2:06

fracture of the squamous portion of the left temporal bone,

2:10

suggests that this patient has an epidural hematoma.

Case: Epidural Hematoma on CT

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