**Question:** A 45 year old woman with Intracranial extradural hemorrhage is presented with all except

A. altered sensorium
B. normal blood pressure
C. normal heart rate
D. minimal or no focal neurological deficits

**Core Concept:** Intracranial extradural hemorrhage (EDH) is a type of traumatic brain injury resulting from bleeding between the skull and the outer layer of brain tissue (dura mater). This type of hemorrhage can lead to increased intracranial pressure, resulting in neurological deficits and life-threatening complications.

**Why the Correct Answer is Right:** Intracranial EDH is characterized by an increased intracranial pressure that can lead to altered sensorium (mental status changes), as it affects the brain's function. In contrast, normal blood pressure and normal heart rate are not directly influenced by the intracranial EDH, making them less likely to be affected.

**Why Each Wrong Option is Incorrect:**

A. Option B: Intracranial EDH can lead to increased intracranial pressure, which may result in cardiovascular compromise (hypotension) or alter organ system functions. However, normal blood pressure does not directly relate to the intracranial EDH.

B. Option C: Intracranial EDH can cause neurological deficits, which may manifest as changes in heart rate due to the effect of increased intracranial pressure on the autonomic nervous system. However, normal heart rate is not a direct consequence of intracranial EDH.

C. Option D: Intracranial EDH can lead to altered sensorium, neurological deficits, and focal neurological signs due to the increased intracranial pressure. In contrast, minimal or no focal neurological deficits is not typical for intracranial EDH, as it generally presents with more significant neurological deficits.

**Clinical Pearl:** Intracranial EDH should prompt an urgent evaluation, as it carries a risk of increased intracranial pressure, neurological deficits, and potential life-threatening complications. Early diagnosis and management can improve patient outcomes.