Extradural hematomas
Rubric
NU621 Unit 6 Case Study
SAMPLE PAPER
Patient Scenario-1
Two individuals come to the emergency department with head injuries. One, 25 years old, has
just been in a motor vehicle accident (MVA) and has a temporal lobe injury. The other, 65 years
old, has increasing confusion after a fall that happened earlier in the week.
Extradural Hematoma vs Subdural Hematoma
McCance and Huether (2014) define extradural hematomas as 1% to 2% of major head
injuries, common in 20 to 40 year olds. Bleeding is located between the dura mater and skull.
The most common mechanism for extradural hematomas to occur is a result of motor vehicle
accidents (MVAs) with 90% being caused by temporal fracture and the temporal fossa being the
primary location. In 85% of extradural hematomas an artery is the main culprit for bleeding.
“The resulting shift of the temporal lobe medially precipitates uncal and hippocampal gyrus
herniation through the tentorial notch” (p. 585). Those with extradural hematomas initially lose
consciousness then have a lucid time period for a few hours to a day or two after depending on if
the bleeding is arterial or venous. During that lucid time is when the bleeding is increasing. This
is ultimately followed by severe headache, drowsiness, nausea, vomiting, potentially seizures,
and confusion (McCance & Huether, 2014). If the patient is not treated in time, herniation
followed by death can occur.
Subdural hematomas account for 10% to 20% of traumatic brain injuries. The most
common cause is motor vehicle accidents (McCance & Huether, 2014). In older adults, falls can
be linked to chronic subdural hematomas. Additionally, subacute hematomas can develop slower
over the course of two days to two weeks. Chronic hematomas develop over two weeks to two
months. Subdural hematomas are a result of venous blood occurring between the dura mater and
arachnoid mater (McCance & Huether, 2014). Depending how many veins are torn will depend
This study source was downloaded by 100000760925736 from CourseHero.com on 12-07-2021 10:08:59 GMT -06:00
https://www.coursehero.com/file/45673848/NU621unit6casestudydocx/
This study resource was
shared via CourseHero.com
