Extradural hematomas: Measurement of size by volume summation on CT scanning

Petersen, O. F.; Espersen, J. O.

doi:10.1007/bf00327488

Cited by 72 publications

(29 citation statements)

References 21 publications

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“…Hematoma volume was measured by the empirical formula of volume (0.5 x height x depth x length) on the basis of distance measurements of the depth and length on the CT slice having the largest area of clot (28). The hematoma thickness was measured as the largest vertical distance between the cortex and the tabula interna ( Figure 1A) and the midline shift as the largest perpendicular distance between an imaginary reference joining the frontal crest and the protuberantia occipitalis interna and the most shifted point of the septum pellucidum ( Figure 1B).…”

Section: █ Materials and Methodsmentioning

confidence: 99%

The surgical outcome of traumatic extraaxial hematomas causing brain herniation

Gürer¹,

Kertmen²,

Yı́lmaz³

et al. 2015

Turkish Neurosurgery

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ABSTRACTcommon clinical entities encountered by any neurosurgical service.Brain herniation due to posttraumatic hematoma remains one of the most difficult situation faced by neurosurgeons, and causes significant mortality and morbidity. To our knowledge there were only few past studies focused especially into the herniated subgroup of traumatic extraaxial hematomas (31,37,43,44).The aim of this retrospective study was to assess the surgical outcome and the prognostic importance of clinical and █ INTRODUCTION A ccident is the leading cause of death among individuals younger than 45 years. Traumatic brain injury (TBI) accounts for approximately 70% of these traumatic deaths and most of the unfavorable outcomes (2). The most important complication of TBI is the development of intracranial hematomas. It is estimated that intracranial hematomas occur in 25-45% of severe TBI, 3-12% of moderate cases and approximately 1 in 500 patients with mild TBI (40). As a result, acute traumatic extraaxial hematomas (epidural hematoma (EDH) and subdural hematoma (SDH)), are among the most AIm: The aim of this study was to assess the surgical outcome and the prognostic importance of clinical and radiological data of patients operated emergently for an extraaxial hematoma causing brain herniation. mATERIAl and mEThODS:This retrospective study comprised 108 adult patients who were operated due to herniated traumatic extraaxial hematomas from January 2000 to January 2013. RESUlTS:Of 108 patients, 63 patients (58.3%) were diagnosed as subdural hematoma (SDH), and 45 patients (41.7%) as epidural hematoma (EDH). An unfavorable outcome was significantly increased for patients who were diagnosed as SDH (90.4%) compared with EDH patients (33.3%). Mortality rate for herniated SDH patients was 65.1%, and 26.6% for herniated EDH patients. High mortality and unfavorable outcome ratios were associated with Glasgow Coma Scale scores at admission, mean postoperative intracranial pressure (ICP) values, type of the brain herniation, interval from the time of trauma to the time of hematoma decompression, the duration of the brain herniation, intraoperative acute brain swelling, hematoma volume and thickness, degree of the midline shift and the obliteration of the basal cisterns. CONClUSION:Our data showed that, postoperative ICP values were one most important predictor of the mortality. We recommended postoperative ICP monitoring for all patients presenting with the brain herniation due to traumatic extraaxial hematoma.

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Section: █ Materials and Methodsmentioning

confidence: 99%

The surgical outcome of traumatic extraaxial hematomas causing brain herniation

Gürer¹,

Kertmen²,

Yı́lmaz³

et al. 2015

Turkish Neurosurgery

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“…The location of the hematoma was described as the lobe that contained most of the hematoma. Hematoma volume was calculated by the empirical volume formula (0.5 × height × depth × length) using the depth and length measurements of the CT slice with the largest area of clot [5]. Hematoma thickness was measured as the largest vertical distance between the cortex and the internal tabula of the bone.…”

Section: Methodsmentioning

confidence: 99%

The Surgical Outcome of Traumatic Extra-Axial Hematomas Causing Brain Herniation in Children

et al. 2013

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Aim: The aim of this study was to assess the surgical outcome and prognostic importance of clinical and radiological data from children operated on under emergency conditions due to an extra-axial hematoma causing brain herniation. Methods: This retrospective study included 25 children operated on due to herniated traumatic extra-axial hematomas from January 2000 to December 2010. Results: Of those 25 children, 17 (68%) were diagnosed with subdural hematoma (SDH), 7 (28%) with epidural hematoma (EDH) and only 1 patient (4%) suffered from both SDH and EDH. Overall mortality from a herniated extra-axial hematoma was 44%. The mortality rate for herniated SDH patients was 52.9%, and only 1 patient died from a herniated EDH (14.2%). Low Glasgow coma scale scores at admission, high postoperative intracranial pressure (ICP) values, longer intervals from trauma to surgery, longer durations of brain herniation, the presence of intraoperative brain swelling, larger and thicker hematomas and more displacement of the midline structures and obliteration of the basal cisterns were all correlated with mortality and an unfavorable outcome. Conclusions: Brain herniation is a serious consequence of traumatic extra-axial hematomas in children, and approximately one third of these patients have the potential for a favorable outcome. We recommend postoperative ICP monitoring to predict outcome and early decompressive surgery when possible for promising results.

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“…22 If there is more than one haematoma, list all of them, specify the location and estimate the volume of each individual bleed and give total by adding volumes. Codes for location are: L = left, R = right, T = temporal, F = frontal, P = parietal, O = occipital, BG = basal ganglia, B = brainstem.…”

mentioning

confidence: 99%

CRASH-2 (Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage) intracranial bleeding study: the effect of tranexamic acid in traumatic brain injury, a nested randomised, placebo-controlled trial.

Perel

Salman²,

Kawahara³

et al. 2012

Health Technol Assess

124

113

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Extradural hematomas: Measurement of size by volume summation on CT scanning

Cited by 72 publications

References 21 publications

The surgical outcome of traumatic extraaxial hematomas causing brain herniation

The surgical outcome of traumatic extraaxial hematomas causing brain herniation

The Surgical Outcome of Traumatic Extra-Axial Hematomas Causing Brain Herniation in Children

CRASH-2 (Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage) intracranial bleeding study: the effect of tranexamic acid in traumatic brain injury, a nested randomised, placebo-controlled trial.

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