these patients will have headaches, nausea, difficulty concentrating, personality
changes and retrograde and/or anterograde amnesia. Long term implications
of concussions have long been known but it has only been recently that
concussion recognition, treatment, management and prevention have gained
increasing notoriety due to professional athletes and media.
Intracranial hemorrhages are classified as epidural, subdural and
subarachnoid hemorrhages. Epidural hematomas are typically associated with
middle meningeal artery injuries and is classically seen on CT as a lenticular
hematoma (Figure 1). The classic presentation in adults is described as a lucid
interval followed by rapid deterioration; however this is rare in children.
Children with large clots > 40mL may require evacuation.
Figure 1: Epidural hematoma: Lens shaped convexity. Most often from skull fractures causing
laceration to the middle meningeal artery
Subdural Age of injury (days)
Acute < 3
Subacute 3 - 10
Chronic >10