International Journal of Advances In Case Reports

A STUDY OF CLINICO-RADIOLOGICAL PROFILE AND OUTCOME OF EXTRADURAL HAEMATOMA – A CASE SERIES STUDY

Vishwanath Sidram1*, Chandra Kumar P C2, Bellara Raghavendra3, Rohith M4

vishwanathsidaramneuro@gmail.com

Extradural Haematoma, RTA, Tempero-parietal

Traumatic extradural haematoma (EDH) is a neurosurgical emergency and timely surgical intervention for significant EDH is the gold standard. The aim of this study is to review the cause, clinico-radiological profile and outcome of traumatic EDH cases admitted in Neurosurgery department. A case series study of 57 patients with traumatic extradural haematoma was carried out in the setting of tertiary care hospital in the department of Neurosurgery, Vijayanagara Institute of Medical Sciences, Bhallari, who were admitted between Jan 2012 to Jan 2014. Variables included in the analysis were age, sex, clinical profile and radiological profile variables. Outcomes were assessed by Glasgow Outcome Scale score(GOSS). A total of 57 patients diagnosed with extradural haematoma were included in the study. The proportion of EDH was more in the second and third decades of life, with a mean age of 26.45 ± 14.17 years. Majority of them were males (91.2%) and females were (8.8%). In majority of patients RTA (84.2%) was cause of injury followed by falls (15.8%). The most common location of haematoma was tempero-parietal 20(35%), followed by frontal 17(29.8%). Associated skull fracture was present in 42(73.7%), parenchymal brain injury in 5(8.8%) patients and axonal injury in 3(5.3%) patients. Midline shift was seen 10(17.5%) of the patients. The mean thickness (size) of the haematoma was 25.1 ± 18.9 mm, ranging from 18 mm to 40 mm. The outcome was assessed by using Glasgow Outcome Scale score where in 24(42%) patients had excellent outcome with GOSS of 5(Low Disability), 25(43.9) patients had good outcome with GOSS of 4(Moderate Disability). We conclude that early appropriate treatment of EDH results in good high quality survival (Glasgow Outcome Score 4 or 5). Low GCS should not be an absolute contraindication for surgery. Seizure prophylaxis should be considered in all cases.