Traumatic Extradural Hematoma: Factors Affecting the Surgical Outcome
Keywords:
Head injury, extradural hematoma, surgical outcome, affecting factorsAbstract
Objective: To determine the factors affecting surgical outcome of traumatic intracranial extradural hematoma in Civil Hospital Karachi. Head injury is a leading cause of death in young age group. Extradural hematoma, a complication of head injury, is often fatal if not treated in time. The surgical outcome of EDH is dependent upon many variables including preoperative GCS, time between injury and surgery, associated intracranial injuries, anisocoria and hematoma volume. In order to reduce the mortality near to nil, it is essential to determine the magnitude of effect of affecting factors on surgical outcome which will also help us in preoperative counseling and prioritizing the operative candidates.
Study Design: Cross sectional study. Six months from 28th May 2012 to 27th November 2012.
Materials and Methods: The study was conducted on the patients admitted through emergency and diagnosed as extradural hematoma. These patients underwent surgical evacuation of EDH on emergent basis and outcome was measured by Glasgow Outcome Scale (GOS) after 48 hours of surgery.
Results: Using GOS, good surgical outcome was observed in 80.9% (157 out of 194) patients. Preoperative GCS, anisocoria, hematoma volume, associated intracranial injuries and time between injury and surgery were the factors affecting the outcome significantly (p value=0.000) while age and sex of the patient had no significant effect.
Conclusion: Good surgical outcome is associated with patients with solitary extra dural hematoma of volume less than 60ml, preoperative GCS more than 8, absence of anisocoria and undergoing surgical evacuation within 6 hours of injury.
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References
Basavaraj KG, Venkatesh HK, Rao GSU. A prospective study of demography and outcome in operated head injuries. Ind J Anaesth 2005; 49:24-30.
Ozkan U, Kemaloglu S, Ozates M, Guzel A, That M. Analyzing extradural haematomas: A retrospective clinical investigation. Dicle Tip Dergisi 2007; 34:14-9.
Bullock MR, Chesnur R, Ghajar J, Gordon D, Hartl R, Newell DW, et al. Surgical Management of acute epidural hematomas. Neurosurgery 2006; 58:52-7
Babu ML, Bhasin SK, Kumar A. Extradural Haematoma-an experience of 300 cases. JK Science 2005; 7:205-7.
Khalid SM, Raihan MZ, Chowdhury FH, Ashadullah AT, Sarkar MH, Hossain SS. Surgical management of traumatic extradural hematoma: Experiences of 610 patients and prospective analysis. Ind J of Neurotrauma 2008; 5:75-9.
Cheung PS, Lam JM, Yeung JH, Graham CA, Rainer TH. Outcome of traumatic extradural haematoma in Hong Kong. Injury 2007; 38:76-80.
Emejulu JK, Shokunbit MT, Malomo AO. Determinants of outcome in operative treatment of traumatic extradural haematoma. West Afr J Med 2008; 27:32-6.
Ayub S, Ali M, Ilyas M. Acute extradural hematoma: factors affecting the outcome. J Postgrad Med Inst 2005; 19:208-11.
Mushtaq, Rehman L, Khaleeq S, Khaleeq-uz-Zaman. Association of outcome of traumatic extradural hematoma with glasgow coma scale and hematoma size. Ann Pak Inst Med Sci 2010; 6:133-8.
Outcome assessment. In: Greenberg MS, editor. Handbook of neurosurgery. NewYork: Thieme; 2010. P. 1183.
Bhau KS, Bhau SS, Dhar S, Kachroo SL, Babu ML, Chrungoo RK. Traumatic extradural hematoma - role of non-surgical management and reasons for conversion.Ind J Surg 2010; 72:124-9.
Roka YB, Kumar P, Bista P, Sharma GR, Adhikari P. Traumatic posterior fossa extradural haematoma. JNMA J Nepal Med Assoc 2008; 47:174-8.
Bejjani G, Donahue D, Rustin J, Broemeling L. Radiological and clinical criteria for the management of epidural hematomas in children. Pediatr Neurosurg 1996; 25:302-8.
Bricolo A, Pasut L. Extradural hematoma: toward zero mortality. Aprospective study. Neurosurgery 1984;14:8-12.
Cohen J, Montero A, Israel Z. Prognosis and clinical relevance of anisocoria-craniotomy latency for epidural hematoma in comatose patients. J Trauma 1996; 41:120-2.
Lee EJ, Hung YC, Wang LC. Chung KC, Chen HH. Factors affecting influencing the functional outcome of patients with acute epidural hematomaa: Analysis of 200 patients undergoing surgery. J Trauma 1998; 45:946-52.
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