Management Outcome of Extradural Hematoma
Keywords:
Head injury, Extradural hematoma, Surgical management, Outcome.Abstract
Objectives: To determine the frequency, clinical presentation and surgical outcome of extradural hematoma in head injury patients admitted in tertiary care hospital.
Material and Methods: This descriptive study was conducted in neurosurgery department of Hayatabad Medical Complex, Peshawar from 1st February 2010 to 30th January 2012. A total of 367 patients of head injury, from both genders without age discrimination were included. EDHs caused by bleeding diatheses or vascular malformations, post surgical EDHs and those requiring conservative treatment were not included in the present study. Diagnosis of EDH was confirmed by CT scan brain. Patients' data was documented in a structured proforma and analyzed in SPSS version 17. Frequency and percentage was calculated for categorical variables. Mean ± SD was calculated for age. Results were presented as graphs and tables.
Results: Total 367 patients were included out of which there were 238 (64.85%) males and 129 (35.14%) females. The mean age was 31 ± 1.3 years SD. EDH was most common in the age range of 21 – 30 years (28%). Most of the patients179 (48.77%) had Glasgow coma scale (GCS) in the range of 13 to 15. The commonest presentation was headache i.e. 242 patients (73.11%) and 210 patients (63.44%) had vomiting as presenting complaints. The most common location for EDH in the present study was temporo-parietal region i.e. 113 (30.79%) followed by frontal region i.e. 99 (26.97%).Glasgow outcome score was used to measure the outcome. Outcome was good in 229 patients but predominantly these patients were in GCS 14 – 15 on presentation. Death occurred in 29 (7.90%) patients and 3 (.817%) patients remained in vegetative state. These patients had very low GCS and coning or associated parenchymal or systemic injuries were already present before their operations.
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