The Role of Angiography in the Diagnosis of Extradural Haematomas

Abstract

An extradural haematoma is the most dangerous and dramatic complication of a head injury. It is a distressing feature that although the surgical removal of an extradural haematoma presents little difficulty to a surgeon accustomed to cranial surgery, the mortality from this condition remains disastrously high, varying from 14 to 66 per cent (Table 1). Analysis of mortality figures from any series of extradural haematomas reveals that the majority of deaths are avoidable. Unavoidable mortality due to co-existent severe cerebral injury has been estimated at between 5 to 10 per cent (Hooper, 1959). In a series of 86 consecutive cases of extradural haematoma treated at this centre during a period of three years (1st January 1962 to 31st December 1964), the mortality rate was 14 per cent (12 cases). The unavoidable mortality was only 2·3 per cent (2 cases). The high avoidable mortality rate is usually due to failure to realise the variations in symptomatology and location of extradural haematomas. In this seri...