Impact of The Time Taken Before Surgery in Evaluating the Outcome of Extradural Hematoma


  • Aisha Adalat Department of Neurosurgery, Pakistan Institute of Medical Sciences, Islamabad
  • Lal Rehman Department of Neurosurgery, Pakistan Institute of Medical Sciences, Islamabad
  • Muhammad Mujahid Sharif Department of Neurosurgery, Pakistan Institute of Medical Sciences, Islamabad
  • Hamza Ejaz Department of Neurosurgery, Pakistan Institute of Medical Sciences, Islamabad
  • Kashif Ramooz Department of Neurosurgery, Rawal Institute of Health Sciences, Islamabad
  • Shafiq-ur-Rehman Jamil Department of Neurosurgery, Nawaz Shareef Medical College Gujrat – Pakistan



Extradural Hematoma, Arrival Time


Objective:  To assess the impact of the time taken before surgery in evaluating the outcome of extradural hematoma.

Materials & Methods:  A prospective observational study was done at the Department of Neurosurgery, Pakistan Institute of Medical Sciences (PIMS) Islamabad. Patients with extradural hematoma (>20ml) as per calculation by the scale on axial images of a CT scan brain and scheduled for surgical intervention, aged 18 years to 60 years of either gender were included. Patients underwent surgical treatment as per indications and were scheduled for surgery. Time was recorded for injury, diagnosis, and surgery and calculated from the time of injury to the time of surgery. 

Results:  Overall mean age was 34.09 years with a higher proportion of males (66.7%). Post-surgery, disability was observed in 11.8% of cases and the overall mortality rate was 15.7%. Considering the overall outcomes, 74.5% of the patients had favorable results, whereas 25.5% had unfavorable outcomes. The timing of surgery significantly influenced outcomes (p < 0.0001). Patients operated on within 1-6 hours post-trauma had no disability or mortality, with 70.6% favorable outcomes. In contrast, those operated on within 6-12 hours showed 11.8% disability, 11.8% mortality, and 23.5% unfavorable outcomes, with only 2.0% achieving favorable outcomes.

Conclusion:  It is evident that a time interval of less than six hours between the traumatic incident and surgical intervention is strongly correlated with better results, including significantly lower rates of disability and mortality.

Author Biography

Shafiq-ur-Rehman Jamil, Department of Neurosurgery, Nawaz Shareef Medical College Gujrat – Pakistan




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