Factors Affecting the Outcome of Traumatic Brain Injured Patients with Acute Epidural Haematoma in National Hospital, Abuja

Abstract

Objective: The objective is to determine the prognostic factors affecting the surgical outcome of patients surgically treated for acute epidural haematoma. Materials and Methods: A retrospective review of 71 consecutive patients who underwent neurosurgery for acute epidural haematomas over a 5-year period (from January 2015 to December 2019) was conducted. Clinical characteristics and the time intervals were investigated to determine the interactions between all these factors and the outcome. The outcome was graded according to the Glasgow Outcome Scale (GOS) at subsequent follow-up clinic visits. Results: The severity of traumatic brain injury using the Glasgow Coma Scale score (chi-square test, P = 0.033) had a statistically significant relationship with the outcome. The patients’ age, gender, and total length of time until surgical intervention ( P > 0.05) were of no statistical significance in relation to the outcome. The mortality rate of patients presenting at our centre is 16.9%. Overall, after surgery, 47 of 71 with epidural haematoma had good recovery (GOS 5). Twelve of 71 patients had GOS of 2–4. Twelve patients died. The median duration from injury to presentation was 15 hours with an interquartile range of 15 hours. Conclusion: Our results indicate that the severity of brain injury is an independent risk factor in determining the outcome of epidural haematoma in traumatic brain injury.

Impact of Time from Injury to Surgery on Postoperative Functional Recovery in Large Volume Traumatic Extradural Hematomas

“…In contrast to our results, the study of Ayogu et al 2 failed to demonstrate an association between outcome and the time interval from trauma until surgery. Patients operated upon within the first 6 hours of presentation did not show a significantly better outcome when compared with patients who had surgery later than 6 hours ( p = 0.083).…”

“…Also, Nnadi et al 18 reported that time to surgery did not have significant effect on the outcome ( p = 0.760). The difference between our results and these studies can be explained by the high percentage of patients with mild TBI and high GCS score (13–15) who were included in these studies; 51 and 38% in Ayogu et al 2 and Nnadi et al 18 study, respectively.…”

“…In literature there is agreement that despite being a serious neurosurgical emergency, EDH mostly carries a good prognostic outcome after surgery. 2 11 14 18 19 Fig. 3 illustrates the pre- and postoperative CT scans of a patient who was operated upon for large volume EDH within 6 hours after trauma and despite of having a low GCS on presentation, this patient had postoperative favorable recovery.…”

“…Head injury is a major health problem with high risk of morbidity and mortality. 1,2 Among intracranial hematomas, extradural hematoma (EDH) assumes the greatest importance as it can be easily diagnosed and treated. For large volume EDH, craniotomy and hematoma evacuation is the only way to save patients' life from a potentially fatal benign lesion.…”

Surgical Acute Epidural Hematoma in Temporal Perioral Region of Brain: Case Report

“…Over 2 years, there is usually some progress. 3 Another problem that patients with EDH confront is a permanent coma and herniation of the brain, as well as normal pressure hydrocephalus, which can cause weakness, headaches, incontinence, difficulties walking, paralysis or loss of sensation, and so on. In our scenario, the patient's brain injury is severe, and a neurosurgeon must perform an emergency operation.…”