Acute extradural hematoma analysis-factors influencing the outcome of patients undergoinm surgery in coma

ABSTRACT

Mortality due to extradural hematoma is virtually restricted to patients who undergo surgery while in coma. We have analysed the factors influencing the outcome of 24 patients who underwent evacuation of extradural clot when brought in comatose state. The study was conducted at Sandeman Provincial Hospital, Quetta from December 1994 to October 1996. The study was conducted randomly. Out of 24 patients, 10 patients [42 percent] made a good functional recovery, 7 patients [29 percent] died while 7 were moderately/severely disabled [29 percent]. The factors which affected the overall results were mechanism of trauma, age of patient, interval between trauma and surgery, Glasgow coma score at operation, associated intracranial lesions and hematoma volume etc. The duration of postoperative coma also affected the final outcome. The mortality rate was significantly higher in patients who were operated later than 12 hours [43 percent] than in patients operated on within 6 hours of injury [10 percent]. This study attempts to indentify factors responsible for higher mortality and morbidity in patients with extradural hematoma