ABSTRACT
AIMS: To evaluate the management strategy of extradural hematomas (EDH), particularly with respect to its volume. METHODS AND MATERIALS: Two hundred and three patients with EDH and no other significant intracranial injuries were treated over a period of three years. RESULTS: The factors influencing management strategy and outcome were the Glasgow coma scale (GCS), volume of extradural hematoma (EDHV) and its location. The ultimate clinical outcome was significantly better in patients having EDHV of less than 30 ml. CONCLUSIONS: The key factors influencing the management strategy and clinical outcome are EDHV and GCS at the time of admission. A patient with EDH should not be considered for conservative management if EDHV is more than 30 ml and GCS is 13 or less.
Subject(s)
Adult , Female , Hematoma, Epidural, Cranial/pathology , Humans , Male , Neurosurgical Procedures , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
Os hematomas epidurais espontâneos sao raramente descritos na literatura. Estao associados a doenças infecciosas do crânio, distúrbios da coagulaçao, malformaçoes vasculares da dura-máter e metástases na calota craniana. Os autores relatam dois casos de hematomas epidurais espontâneos de diferentes etiologias e discutem aspectos relacionados à hemostasia.
Subject(s)
Female , Humans , Adolescent , Child , Hematoma, Epidural, Cranial/etiology , Blood Coagulation Disorders/complications , Hematoma, Epidural, Cranial/pathology , Hematoma, Epidural, Cranial/surgery , Sinusitis/complicationsABSTRACT
Los hematomas epidurales crónicos son entidades raras, que pueden producir consecuencias severas si no se diagnostican y tratan a tiempo. Diferentes etiologías se han involucrado en esta patología, como las traumáticas, anticoagulantes, diátesis hemorrágicas, angiomas espinales, y las espontaneas sin causa evidente. Se describe el caso de un paciente de 69 años quien presentó dolor lumbar de 15 dias de evolución, parestesias en miembros inferiores y dificultad para la marcha, con antecedentes de un traumatismo lumbrar un mes antes de su ingreso. La Rx simple, mielografía, mielo-TAC y resonancia magnética, demostraron una fractura-aplastamiento de L1 con una masa intra-espinal D12-L2, donde la limectomíademostró un hematoma epidural crónico con buena recuperación post-operatoria