Outcome of Traumatic Extradural Haematoma Managed Surgically: Our Experience

Abstract

Background: Extradural haematoma (EDH) occurring as a result of traumatic head injury constitutes one of the most critical emergencies in neurosurgery. Objectives: In present retrospective analysis we reviewed 27 patients treated for EDH at our Institute over a period of one year (January 2006 to December 2006) under neurosurgical services and discuss our experience in relation to the management of these lesions and patient outcome Results: Total 604 patients were managed for head injuries from January 2006 to December 2006. Twenty seven consecutive patients with EDH were managed over a period of one year. Majority of the patients were young male with a male to female ratio of 3.5:1. Most common cause was road traffic crashes (67%) followed by falls (26%). Most common presentation was loss of consciousness (81%) followed by vomiting (44%). On admission, 23 (86%) patients were GCS 13-15, 2 (7%) GCS 9-12 and 2 (7%) GCS 3-8. All patients underwent a craniotomy (burr hole or trephine) or a craniectomy and evacuation of the haematoma. Overall, four patients (15%) died. Mortality was mainly due to poor neurological grade and in patients with dilated fixed pupils. One patient had associated cervical spine injury and developed respiratory failure and succumbed to it. Conclusions: Extradural haematoma is a neurosurgical emergency and timely intervention gives rewarding results. Early detection and aggressive approach is needed to manage these lesions. Keywords: Epidural haematoma, extradural haematoma, trauma, head injury Nigerian Journal of Orthopaedics and Trauma Vol. 6 (2) 2007: pp. 74-76