Extradural Hematomas in Children

Santos, Alberto L. Moura dos; Plese, José Píndaro Pereira; Ciquini, Orildo; Bor-Seng-Shu, Edson; Manreza, Luiz Alcides; Marino, Raul

doi:10.1159/000120814

Cited by 26 publications

(7 citation statements)

References 12 publications

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“…Comparing the results from these two studies in our unit (1987-1991 versus 2006-2008) 6 , we found that falls continued to be a common cause of trauma, but that there had been significant growth in the proportion of cases due to automobile accidents (from 1.7% to 33%). This can perhaps be explained by the large increase in the vehicle fleet in our city that has taken place over this interval.…”

Section: Discussionmentioning

confidence: 73%

“…These intracranial lesions in children represent 2 to 3% of all head injury complications 1,6 . Consistently with other series, falls were the most common cause of trauma in our series.…”

Section: Discussionmentioning

confidence: 99%

“…The reported incidence of EDH after head trauma in hospitalized children ranges from 1% to 6% 3,4 . However some authors have reported an increased incidence of unassociated EDH over recent years 5,6 . Its diagnosis can be quite challenging because its clinical presentation is usually subtle and nonspecific.…”

Section: Supratentorial Epidural Hematoma In Childrenmentioning

confidence: 99%

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Management of supratentorial epidural hematoma in children: report on 49 patients

Paiva

Andrade

Júnior

et al. 2010

Arq. Neuro-Psiquiatr.

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Traumatic head injury is a common cause of mortality and acquired neurological impairment in children. However, pediatric epidural hematomas (EDHs) are not common and few series have studied the evolution of these patients. In this study, we present the results from a sample of patients with EDH with long-term follow-up. Method: Between January 2006 and December 2008, 49 patients with traumatic EDH were treated at our unit. Clinical course, radiological findings and outcomes were evaluated. Neurological status was assessed using the Glasgow Coma Scale (GCS). The patients' ages ranged from one day to 16 years. The mean follow-up was six months. Results: On admission, most of the patients presented mild trauma and 57% had a GCS of 13-15. The most common symptom was irritability. The most frequent mechanisms of injury were: falling from a height in 29 cases and motor vehicle accidents in 16 cases. Three of these patients presented GCS 3, but only one died. We found a late neurological deficit in nine patients. Conclusion: These lesions may occur following mild head trauma and in alert children with nonfocal neurological examinations. However, in children presenting irritability with subgaleal hematomas and a history of loss of consciousness, skull computed tomography must be performed. Key words: epidural hematoma, head trauma, children.Tratamento de hematoma epidural supratentorial em crianças: avaliação em 49 pacientes RESUMO Trauma craniocerebral é uma causa frequente de mortalidade e comprometimento neurológico adquirido em crianças. No entanto, hematomas epidurais (HED) são raros em pacientes pediátricos, com poucas series estudando a evolução destes pacientes. Neste estudo, os autores apresentam os resultados de uma casuística de pacientes com HED acompanhados em longo prazo. Método: Entre janeiro de 2006 e dezembro de 2008, 49 pacientes com HED foram tratados em nossa unidade. Curso clínico, achados radiológicos, e resultados foram avaliados. O estado neurológico foi avaliado com o Glasgow Coma Scale (GCS). A idade variou de 1 dia a 16 anos. A média de acompanhamento foi de 6 meses. Resultados: Na admissão, a maioria dos pacientes apresentava trauma leve e 57% estavam com GCS de 13-15. O sintoma mais comum foi irritabilidade. Os mecanismos de trauma mais frequentes foram queda de altura em 29 casos e acidentes de trânsito em 16 casos. Três destes pacientes apresentavam GCS 3, mas somente um morreu. Verificou-se déficit neurológico tardio em nove pacientes. Conclusão: Esta lesão pode ocorrer após traumas leves e em crianças alerta com exames neurológicos não focais. No

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Section: Discussionmentioning

confidence: 73%

“…These intracranial lesions in children represent 2 to 3% of all head injury complications 1,6 . Consistently with other series, falls were the most common cause of trauma in our series.…”

Section: Discussionmentioning

confidence: 99%

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Management of supratentorial epidural hematoma in children: report on 49 patients

Paiva

Andrade

Júnior

et al. 2010

Arq. Neuro-Psiquiatr.

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“…Frontal epidural hematomas are often associated with parenchymal injuries in both adults and children. 2,19,20 Hematomas are more often attributable to falls in children and to motor vehicle accidents in adults. 2,19,20 Children more frequently present with diffuse injury and cerebral swelling with resultant intracranial hypertension compared to adults,1,21,22 and up to 44% of children exhibit diffuse cerebral swelling after severe traumatic brain injury.…”

Section: Epidemiology and Mechanisms Of Injurymentioning

confidence: 99%

Topical Review: Head Injury in Children

1998

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Trauma in the United States is the leading cause of death and disability in the pediatric population. Differences of age and development affect recovery and outcome following head injury. Mechanisms and pathophysiology of head injury are varied in both the pediatric and adult populations. Assessments of injury are varied and some measurements are more sensitive than others as well as more specific with regard to certain types of injury. Treatment and management should be tailored to each case in order to effect a positive outcome with respect to brain functioning. Aggressive intervention for prevention of primary and secondary injury must be continued and understanding of the impact of these injuries should provide for a brighter future for these patients.

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“…Most of the literature stated that the incidence of EDH in pediatric head injury is very low ranging from 2% to 3%. [ 3 4 5 ] But in some recent series study, it is found that EDH in pediatric head injury ranges from 9% to 22%. [ 6 ] Many of the studies were done on surgically managed EDH cases which showed a low rate of incidence.…”

Section: Discussionmentioning

confidence: 99%

Supratentorial extradural hematoma in children: An institutional clinical experience of 65 cases

et al. 2015

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Aim and Objective:To survey the epidemiology, management, and severity of extradural hematoma (EDH) in children.Materials and Methods:All patients of EDH (n = 65) in the age group of 0–16 years admitted to our department during the period of August 13 and July 14 were analyzed retrospectively from the hospital records. In all patients, age, sex, mode of injury, clinical presentation, site of EDH, management, duration of hospitalization, and outcome were evaluated.Observation and Results:Of 65 patients, males were 70.76% with a male to female ratio of 2.4:1, most of the victims (47.69%) were in the age group of 11–16 years. Mean duration of hospitalization was 4.32 days. The most common mode of injury was fall from height in 29 cases (44.61%) followed by road traffic accident (RTA) in 23 cases (35.35%). Temporoparietal EDH was the most common computed tomography finding present in 22 (33.84%) patients. 67.69% patients presented to casualty with minor head injury having Glasgow coma scale (GCS) between 14 and 15. Most common presenting feature was vomiting in 52 cases (80%) and next to it was altered sensorium. The mortality rate was 7.69% (n = 5).Conclusion:Extradural hematoma is a life-threatening entity encountered in pediatric head injury. Timely intervention and diagnosis decrease mortality to a great degree. Most of the mortality is encountered in patients who presented late at the neurosurgical unit with low GCS.

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Extradural Hematomas in Children

Cited by 26 publications

References 12 publications

Management of supratentorial epidural hematoma in children: report on 49 patients

Management of supratentorial epidural hematoma in children: report on 49 patients

Topical Review: Head Injury in Children

Supratentorial extradural hematoma in children: An institutional clinical experience of 65 cases

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