What is the classic sign of an epidural hematoma?

• A. Initial unconsciousness with lucid interval
• B. Severe headache
• C. Vomiting
• D. Unilateral fixed dilated pupil

Answer: (A)

The classic sign is a transient loss of consciousness at the moment of injury, followed by a lucid interval where the person seems normal, and then rapid neurological deterioration as the hematoma expands. This pattern happens because arterial bleeding into the epidural space (often from a ruptured middle meningeal artery after a temporal bone fracture) accumulates quickly, raising intracranial pressure. Other symptoms like a severe headache or vomiting can occur with head injury, and a unilateral fixed dilated pupil can signal herniation, but the defining sequence that points to an epidural hematoma is the initial loss of consciousness with a lucid interval before decline.