Pediatric patients with traumatic epidural hematoma at low risk for deterioration and need for surgical treatment

Paediatric mild head injury: is routine admission to a tertiary trauma hospital necessary?

“…However, the likelihood of expansion of a small intracranial haematoma into a surgical lesion is low . In our study, 144 of 410 children had a progress head CT scan and only two evolved delayed surgical lesions which needed intervention.…”

“…In our study children in the TBI surgery group had a larger blood clot ( n = 18, mean thickness of 2.3, 0.8 cm midline shift) compared to children with EDH conservatively managed ( n = 97, mean thickness 0.5 cm, 0 midline shift, P value <0.001). Children with EDH ≤15 mL and no mass effect have very low risk evolving a surgical lesion (98% positive predictive value) . Majority of traumatic EDH in children can be managed conservatively with excellent outcomes …”

“…Children with EDH ≤15 mL and no mass effect have very low risk evolving a surgical lesion (98% positive predictive value) . Majority of traumatic EDH in children can be managed conservatively with excellent outcomes …”

Repeat Head CT for Expectant Management of Traumatic Epidural Hematoma

“…Subjects were identified from a previously published study regarding the conservative (nonsurgical) treatment of pediatric EDHs and from the PCH trauma registry. 9 The University of Utah Institutional Review Board approved the study protocol and waived the requirement for informed consent.…”

“…The EDH volume was calculated by using the formula for an ellipsoid. 9,10 The reviewers were blinded to the CT scan effect on care management.…”