Outcome prediction in extradural haematomas

Cook, Raymond; Dorsch, N; Fearnside, Michael R.; Chaseling, Ray

doi:10.1007/bf01790766

Cited by 45 publications

(29 citation statements)

References 11 publications

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“…Miller et al 9 reported that 183 patients with intracranial hemorrhage after "minor" head injury arrived in an alert condition with a GCS score of 15; 57% had no clinical signs. Likewise, Cook et al 10 reported that among 100 patients with traumatic epidural hematoma and GCS of 14 or 15, 40% had nausea or vomiting but no focal neurological signs. Although it is desirable to have cranial CT scans for all patients with TBI, it can be recognized that this is not viable everywhere.…”

Section: Discussionmentioning

confidence: 97%

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: 97%

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

Paiva

Andrade

Júnior

et al. 2010

Arq. Neuro-Psiquiatr.

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“…Mortality following treatment of EDH varies from 5 to 43 percent (Cook et al, 1988;Jamjoom et al, 1992;Phonprsert, 1980;. Mortality is low (5 to10 percent) in children and increases sharply in those over age 40 (35 to 50 percent).…”

Section: Outcomementioning

confidence: 99%

Traumatic Extradural Hematoma Overview, Clinical Study and Management

Alakaishy¹,

Hejaju²,

Yaqoobi³

et al. 2017

Int.J.Curr.Res.Aca.Rev.

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Article InfoThe study was conducted at neurosurgical hospital in Baghdad depending on patient's case sheet data. The study was carried retrospectively. The patients from 1.1.2004 till 1.5.2005 were taken in consideration and we found 50 cases treated by surgical intervention and 12 cases treated conservatively. Patients with EDHs less than 0.5 cm were treated conservatively and those with postoperative EDHs of elective neurosurgical procedures in addition to incompletely filled patients' files were excluded. All patients data were recorded including the demographic characteristics and clinical parameters: side, site and size of haematoma (maximum thickness). The study concluded that conservative treatment had a role in management of EDHs.

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“…In some studies the size of the hematoma, rather than its location, the degree of midline shift were the most influential in deciding in favor of surgical treatment in asymptomatic significant EDH [22,23]. But temporal location of EDH with heterogeneous density in patients whose CT scan was performed <6 hours after trauma had a higher risk of hematoma growth and thus should be treated surgically [24].…”

Section: Vmentioning

confidence: 99%