A 24-year-old man is brought to the emergency department after his head was hit with a bat during a baseball game. His teammates state that he was unresponsive after the incident but regained consciousness after 15 minutes. The patient initially refused to go to the hospital and sat on the bench for the remainder of the game. He initially appeared fine but became increasingly confused. He appears lethargic but opens his eyes to loud verbal commands. He is oriented to person and place. His temperature is 37.1°C (98.8°F), pulse is 78/min, respiratory rate is 16/min, and blood pressure is 148/87 mm Hg. Examination shows an area of soft-tissue swelling over the left temporal region. The left pupil is mildly dilated. Brain imaging would most likely reveal blood accumulating between which of the following tissues?

Question

A 24-year-old man is brought to the emergency department after his head was hit with a bat during a baseball game. His teammates state that he was unresponsive after the incident but regained consciousness after 15 minutes. The patient initially refused to go to the hospital and sat on the bench for the remainder of the game. He initially appeared fine but became increasingly confused. He appears lethargic but opens his eyes to loud verbal commands. He is oriented to person and place. His temperature is 37.1°C (98.8°F), pulse is 78/min, respiratory rate is 16/min, and blood pressure is 148/87 mm Hg. Examination shows an area of soft-tissue swelling over the left temporal region. The left pupil is mildly dilated.  Brain imaging would most likely reveal blood accumulating between which of the following tissues?

Quizplus · Accepted Answer

Eductional Objective: Epidural hematoma is an accumulation of blood between the bone and dura mater.  It typically occurs due to a tear of the middle meningeal artery associated with fracture of the pterion region of the skull (often involving the temporal bone).  Patients characteristically have transient loss of consciousness followed by a lucid interval before increasing intracranial pressure leads to neurologic deterioration.

A 24-Year-Old Man Is Brought to the Emergency Department After