THE ACCEPTED classic syndrome attending extradural hemorrhage is that of unconsciousness following injury, a lucid interval, a second period of unconsciousness, motor and sensory phenomena, and clear spinal fluid under increased pressure. This picture is thought by many authorities to arise only as a consequence of arterial bleeding which presents sufficient force to strip the dura from the internal surface of the calvarium to produce an acute, compressive, hemorrhagic tumor.
When this sequence of events is present in a person who has suffered a head injury, the diagnosis of an extradural hematoma is immediately obvious. That such a diagnosis is seldom so obvious is attested to by the presence of extradural hematomas in 12 to 20% of fatal head injuries.1 In addition, during the past several years, reports have appeared suggesting that this so-called "classic progression" of disorders is the exception rather than the rule. In this regard, Brodin