Conservative Management of Extradural Hematoma in Minor Head Injury
Keywords:
Minor head injury, extradural hematoma, epidural hematoma, Glasgow Coma ScaleAbstract
Objective: To determine the frequency of favourable outcome in conservative management of extradural hematoma in minor head injury.
Material and Methods: A total of 100 patients with head injury having extradural hematoma were selected for this study. This study was conducted from 15th August 2009 to 14th February 2010 at Department of Neuro-surgery, Lahore General Hospital Lahore.
Results: Patients aged 5 to 60 years of both genders. Extradural hematoma was confirmed on CT scan brain in every minor head injury patient. Patients with extradural hematoma associated with moderate or severe head injury, extradural hematoma of any size with midline shift or effacement of ventricle and extradural hematoma in posterior fossa of any size were excluded from study. Follow up of CT scan was done within 8 hours and then after two weeks. In case of determination of GCS scan brain was done immediately. The mean age of the patients was 21.8 ± 9.7 years. There were 72 (72%) male and 28 (28%) female patients with male to female ratio of 2.6:1. Glasgow Coma Scale (GCS) was 14 in 69 (69%) and 15 in 31 (31% patients. Most of the patients (32%) were suffered in frontal site. The most significant factors associated with unfavourable outcome were younger age. There were (92%) patients had favourable while (8%) were un-favourable and were operated for removal of extradural haematoma. There was no mortality.
Conclusion: Small extradural haematoma can be managed conservatively in minor head injury, these cases especially frontal and narrative occipital region. However follow up CT scan brain should be performed in these 48 hours and at 2 weeks or any time when patient determines. If there is deterioration patient should be operated upon. Removal of extradural haematoma there was no mortality.
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Copyright (c) 2013 Muhammad Ajmal Khan, MUHAMMAD ANWAR, MUHAMMAD AKMAL, Naveed Ashraf, Khalid MahmoodThe work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).