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Elbow Strike to the Temple: Mechanism, Risks & Emergency Response

Anatomic Vulnerability

The temple (pterion) is thin skull overlying:

  • Middle meningeal artery
  • Frontal/temporal lobes
  • Cranial nerves III, IV, V₁, VI (cavernous sinus)

Potential Injuries

  • Epidural hematoma (arterial bleed → rapid compression)
  • Concussion, contusion, diffuse axonal injury
  • Skull fracture (depressed, basilar)
  • Cranial nerve palsies (III – pupil, VI – abduction)
  • Carotid-cavernous fistula

Immediate Actions

  1. Assess responsiveness (GCS), pupils, airway.
  2. Immobilize cervical spine.
  3. Call EMS / transport to trauma center.
  4. Do NOT give oral fluids/meds.

Even "mild" impact warrants CT head if any neurologic sign.

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