'Intracranial Hemorrhage.' American Journal of Respiratory and Critical Care Medicine 184.9 (2011): 998-1006 Emergent evacuation of the hematoma is often necessary to prevent these sequelae. Evidence of herniation may be found in a fixed, dilated (вЂњblownвЂќ) pupil, reflecting ipsilateral cranial nerve III compression by the uncus. METHODS The study population consisted of 3 patient groups evaluated by MRI 2 to 5 days after lumbar decompression with or without fusion. This can result in respiratory arrest, coma, and death. Magnetic resonance imaging (MRI) measures of hematoma size or mass effect may correlate with postoperative symptoms. With uncorrected elevated ICP, uncal or tonsillar herniation can occur, leading to brainstem compression. Other symptoms of increased ICP include headache, severe nausea and projectile vomiting. With elevated ICP, patients may exhibit the Cushing reflex, a triad of hypertension, bradycardia and respiratory depression. As with many types of intracranial hemorrhage, the gravest consequences are the result of severely elevated intracranial pressure (ICP).During this interval, the patient may be awake and alert, but rapid deterioration leading to stupor, coma, and death can occur over minutes to hours. The classical history of an epidural hematoma is loss of consciousness after a closed head injury, followed by a вЂњlucid intervalвЂќ.If the hematoma is large enough, uncal or tonsillar herniation can occur. Clinically, motor function was normal, no sign of suspected hemiparesis. prior GCS was 6 with the unequal pupil, mydriatic on the right side. This blood collection can create a mass effect, yielding midline shift of the brain and ventricular compression. Epidural Hematoma (EDH) or Subdural Hematoma (SDH). Importantly, because the dura has attachments at the suture lines of the skull, arterial blood cannot spread beyond these boundaries and thus develops into a classically described вЂњbiconvex lensвЂќ shape that can be appreciated on non-contrast CT of the brain. Fracture of the temporal bone and consequent rupture of the middle meningeal artery results in collection of blood between the dura and the skull. Epidural hematomas are arterial hemorrhages often associated with traumatic head injury.Their clinical presentation is characterized by a вЂњlucid intervalвЂќ prior to potentially catastrophic neurological sequelae and imaging shows a вЂњbiconvex shapedвЂќ blood collection. The possible causes of unequal pupil sizes are varied. editor / Gerard Tortora Bryan Derrickson. Epidural or extradural hematoma (EDH), which is a collection of blood between the inner table of skull and dura mater occurs in 1 - 5 of TBI. Pupil is the black part in the center of the eye which becomes larger in dim light. Epidural hematomas are a subtype of intracranial hemorrhage due to arterial bleeding between the dura and the skull. Rogers, Katherine./ Epidural Haematoma.Essentials of Anatomy and Physiology (International Student Version).Contributed by: Yousuf Qaseem, University of New Mexico School of Medicine, 1 University of New Mexico, Albuquerque, NM 87131

Epidural hematoma unequal pupil size