Outcome of acute traumatic extradural hematoma

ABSTRACT

To assess the surgical outcome of acute extradural hematoma in terms of neurological recovery and survival. Study Design: Case series. Place and Duration of Study Postgraduate Medical Institute, Neurosurgery Unit, Hayatabad Medical Complex, Peshawar, from January to October 2006. Methodology: All patients admitted and operated for acute traumatic extradural hematoma during the study period were included. Demographic data, history, mode of trauma, examination findings, investigations and outcome were recorded. Glasgow coma scale was used for initial assessment and Glasgow outcome scale was applied to assess outcome in terms of neurological recovery in all patients. The follow-up period was 3 months. A total of 30 patients were operated during the period of 10 months including 22 males and 8 females. Patients were in the age range of 20-30 years comprised 30% of all. Most common causes were road traffic accident [50%], fall from height [33%] and assault [17%]. Patients were divided according to the initial Glasgow Coma Score [GCS] after resuscitation. The GCS was 3-8 in 6 patients, 9-12 in 7 patients, 13-15 in 17 patients. Twenty-four patients had good outcome, one patient had moderate disability in the form of left sided weakness, one patient remained in vegetative state, while 3 [10%] patients died. Chi-square test was significant for good outcome in patients with GCS 13-15 [p=0.01] and for death in patients with GCS 3-8 [p=0.01]. Extradural hematoma in head injuries affected young males more commonly. The outcome was better when the initial GCS was in the higher range