A temporal bone fracture with middle meningeal artery laceration most likely causes which type of hematoma?

• A. Subdural hematoma
• B. Intracerebral hematoma
• C. Epidural hematoma
• D. Subarachnoid hemorrhage

Answer: (C)

When the temporal bone is fractured, the middle meningeal artery, which runs along the inner skull near the temple, can be torn. This arterial bleed pushes blood into the space between the skull and the dura mater, forming an epidural hematoma. Because it’s arterial, the bleed tends to accumulate quickly, often with a brief lucid interval followed by rapid neurological decline. On CT, it appears as a lens-shaped (biconvex) collection that is initially confined by suture lines. This pattern distinguishes it from a subdural hematoma, which is venous and crescent-shaped, a intracerebral hematoma, which is within brain tissue, or a subarachnoid hemorrhage, which spills into the subarachnoid space.