Prognostic factors in severely head injured adult patients with epidural haematoma's

Servadei, Franco

doi:10.1007/bf01808821

Cited by 37 publications

(20 citation statements)

References 43 publications

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“…A possible explanation for this difference might be the fact that these studies included only patients where EDH was the predominant injury whereas in our study most patients with EDH had additional intracranial lesions that might have influenced outcome. Another German study (Regel et al) [10] stated that mortality of EDH was commonly 0-40%, and Servadei [11], summarizing other studies from various authors, reported a rate between 9% and 59%. All of these studies deal with operatively and nonoperatively treated cases.…”

Section: Discussionmentioning

confidence: 97%

Severe Traumatic Brain Injury in Austria V: CT findings and surgical management

Leitgeb

Erb²,

Mauritz

et al. 2007

Wien Klin Wochenschr

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Section: Discussionmentioning

confidence: 97%

Severe Traumatic Brain Injury in Austria V: CT findings and surgical management

Leitgeb

Erb²,

Mauritz

et al. 2007

Wien Klin Wochenschr

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“…It helped us to diagnose EDH in all 36 patients in our series. Older studies showed the role of cerebral angiography in diagnosing EDH (4,21). However, CT scan become the investigation of choice to diagnose the volume and location of EDH, associated injuries and midline shift etc.…”

Section: █ Discussionmentioning

confidence: 99%

“…(16). It has been reported that the mortality rate was between 29 and 33% in the pre-CT era and between 9 and 12% in the post-CT era (4,21). Persistent headache and vomiting are important indications for a CT scan after head trauma (16).…”

Section: █ Discussionmentioning

confidence: 99%

Burr hole evacuation of extradural hematoma in mass trauma, a life saving and time saving procedure: our experience in earth quake of oct 8th, 2005.

Aurangzeb

Ahmed²,

Maqbool³

et al. 2012

Turkish Neurosurgery

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The present study was performed in patients with EDH in order to define the clinical outcome of EDH evacuated through a single burr hole. █ MATERIAl and METhODSThis descriptive study was performed in the Department of Neurosurgery, Ayub Teaching Hospital (ATH), Abbottabad, Pakistan from 8 th October to 12 th October 2005, during the earthquake. ATH is 1000-bed hospital with a well-established unit and serving about 7 million population. We had two qualified neurosurgeons at the time of the earthquake. On the first day of the earthquake 18 patients were operated for EDH, followed by 13 patients on the second day and 6 patients on the third day. █ INTRODUCTIONHead injury is a major health problem. It is reported that 1% of all deaths and 15% of deaths occurring between 15 and 24 years are secondary to head injury (12,16). The major cause of preventable deaths in head injuries is a delay in diagnosis and treatment of intracranial hematomas (16,20).Deterioration of conscious level and developing focal neurological signs signify a rapidly growing extradural hematoma (EDH) (16). In these cases, an urgent computed tomography (CT) scan will reveal biconvex hyperdense EDH causing effacement of the ventricle and midline shift. Craniotomy/craniectomy and evacuation of the hematoma is the treatment of choise to save the life of these patients (16). AIM:To observe the outcome of burr hole evacuation of extradural hematoma (EDH) in mass head injury. MATERIAl and METhODS:This study included patients of any age who sustained head injury in the earthquake of October 8, 2005, were diagnosed as EDH on computed tomography (CT) scan and were admitted in the neurosurgery ward over a period of 3 days. All patients were followed by serial CT scans and neurological assessments. RESUlTS:A total of 36 patients were included in this study. There were 25 male and 11 female patients and the age range was from 5 years to 50 years. All cases were the victim of the earthquake. All patients underwent surgery for evacuation of EDH through a single burr hole. One patient required craniotomy for EDH due to neurological deterioration on the second postoperative day, and 1 patient died. CONClUSION:As EDH is potentially fatal lesion, evacuation of EDH through a single burr hole has good outcome with less chances of recurrence and complications in mass head injured patients as seen with earthquakes.

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“…The most important neurosurgical problem with an extra-axial hematoma is the occurrence of a brain herniation due to rapid enlargement of the hematoma [7,8]. Brain herniation is a catastrophic factor and can lead to mortality via brainstem ischemia [9].…”

Section: Discussionmentioning

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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Prognostic factors in severely head injured adult patients with epidural haematoma's

Cited by 37 publications

References 43 publications

Severe Traumatic Brain Injury in Austria V: CT findings and surgical management

Severe Traumatic Brain Injury in Austria V: CT findings and surgical management

Burr hole evacuation of extradural hematoma in mass trauma, a life saving and time saving procedure: our experience in earth quake of oct 8th, 2005.

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

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