Haemorrhage, epidural

Haemorrhage between the skull and the outermost layer of the membrane enveloping the brain and spinal cord (dura), usually caused by an accident. Cranial fracture may also be present. The characteristic feature is that the patient recovers after a short period of unconsciousness, but then gradually becomes more dazed from pressure on the brain as a result of the haemorrhage. Constriction of brain tissue leads to an increasingly deep coma, associated with a wide-open pupil which no longer reacts to light on the same side as the haemorrhage, and paralysis on the opposite side of the body. In order to diagnose the condition the skull is X-rayed, and a crack is often visible. A CAT scan of the brain clearly shows the haemorrhage, but sometimes there is scarcely time for such examination, and an operation should take place immediately. The haemorrhaging blood vessel is tied off and as much as possible of the shed blood removed. If action is

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