What are the potential complications of extradural haematoma that I should be aware of when managing these patients?

Potential complications of extradural haematoma to be aware of when managing these patients include:

• Neurological deterioration due to increased intracranial pressure, which may manifest as a decreasing Glasgow Coma Scale (GCS) score, focal neurological deficits, or seizures. This requires urgent neurosurgical assessment and intervention ¹.
• Persistent coma or unexplained confusion lasting more than 4 hours, indicating significant brain injury and the need for neurosurgical involvement ¹.
• Progressive focal neurological signs, which may indicate expanding haematoma or secondary brain injury ¹.
• Potential pituitary dysfunction (hypopituitarism) presenting immediately or delayed, with symptoms such as hypotension, hyponatraemia, fatigue, or hormonal deficiencies, necessitating consideration and possible investigation especially if abnormal sodium or blood pressure persist ¹.
• Risk of post-concussion syndrome with symptoms including headache, dizziness, cognitive difficulties, and sensory disturbances, which can occur even after mild head injuries ¹.
• Complications related to skull fractures associated with extradural haematoma, such as cerebrospinal fluid leak or penetrating injury, which require careful assessment and possible neurosurgical referral ¹.

Close monitoring with documented neurological observations (GCS, pupil size/reactivity, limb movements, vital signs) at frequent intervals is essential to detect early signs of deterioration ¹.