Clinical Connections Practice Test 2026 - Free Practice Questions and Study Guide

A key sign of an epidural hematoma is a dilated pupil on the same side as the bleed. This happens because the accumulating blood creates pressure that compresses the oculomotor nerve (cranial nerve III) and its parasympathetic fibers, which normally constrict the pupil. When those fibers are pressed, the pupil becomes enlarged and may be unreactive to light. This pupillary change is often an early and characteristic clue as the brain tissue shifts and the temporal lobe may herniate, even before other neurological signs become prominent.

Fever, skin rash, and cough aren’t typical features of an epidural hematoma; they point to infection, a dermatologic reaction, or a respiratory issue, not the mass effect inside the skull that defines this condition.