Lucid interval

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

In emergency medicine, a lucid interval is a temporary improvement in a patient's condition after a traumatic brain injury, after which the condition deteriorates. A lucid interval is especially indicative of an epidural hematoma. After the injury, the patient is momentarily dazed or knocked out, and then becomes relatively lucid for a period of time which can last minutes or hours. Thereafter there is rapid decline as the blood collects within the skull, causing a rise in intracranial pressure, which damages brain tissue. In addition, some patients may develop "pseudoaneurysms" after trauma which can eventually burst and bleed, a factor which might account for the delay in loss of consciousness.[1]

Because a patient may have a lucid interval, any head trauma should be regarded as a medical emergency and warrants emergency medical treatment even if the patient is conscious.

Delayed cerebral edema, a very serious and potentially fatal condition in which the brain swells dramatically, may follow a lucid interval that occurs after a minor head trauma.[2]

Lucid intervals may also occur in conditions other than traumatic brain injury, such as heat stroke[3] and the postictal phase after a seizure in epileptic patients.[4]

References

  1. Roski, RA (1981). "Middle meningeal artery trauma". Surgical Neurology. Elsevier Science Inc. 17 (3): 200–203. PMID. Unknown parameter |coauthors= ignored (help); |access-date= requires |url= (help)
  2. Kors, EE (2001). "Delayed cerebral edema and fatal coma after minor head trauma: role of the CACNA1A calcium channel subunit gene and relationship with familial hemiplegic migraine". Annals of Neurology. 49 (6): 753–760. PMID 11409427. Unknown parameter |coauthors= ignored (help); |access-date= requires |url= (help)
  3. Casa, DJ (2005). "Exertional heat stroke in competitive athletes". Current Sports Medicine Reports. 4 (6): 309–317. PMID 16282032. Unknown parameter |coauthors= ignored (help); |access-date= requires |url= (help)
  4. Nishida, T (2005). "Postictal mania associated with frontal lobe epilepsy". Epilepsy and Behavior. 6 (1): 102–110. PMID 15652742. Unknown parameter |coauthors= ignored (help); |access-date= requires |url= (help)



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