A Life Threatening Problem in Children; Extra Dural Hematomas. Analysis of 65 Cases
Abstract
Aim: We present this study about the management of Extra Dural Hematomas in children using aggressive diagnostic approach, Prompt surgical intervention was the goal to get excellent results. Material and
Methods: Sixty five children underwent surgery in our department from Jan. 2010 to Dec. 2014. Data was gathered in terms of age, sex, mode of injury, clinical presentation, CT scan finding, and localization of hematoma, operative treatment and outcome.
Results: Out of 65 cases 44 (68%) were boys and 21 (32%) were girls with a ratio of 2:1. Age ranged from 1–18 years with majority 48 (64%) were from 6 – 18. Most common mode of injury was fall 35 (54%) followed by RTA 25 (38%). The commonest clinical presentation was altered sensorium 42 (63%) followed by headache and vomiting 36 (54%). Mortality rate was 4 (6%).
Conclusion: As early symptoms in children with EDH are quite non-specific, EDH must be considered in any child whose condition does not improve rapidly following a relatively mild head injury. Early diagnosis and emergency surgical treatment of EDH result in excellent outcome.
References
2. Ben Abraham R, Lahat E, Sheinman G, Feldman Z, Barzilai A, Harel R, Barzilay Z, Paret, G: Metabolic and clinical markers of prognosis in the era of CT imaging in children with epidural haematoma. Pediatr Neurosurg. 2000; 33: 70-75.
3. Bor-Sen-Shu E, Aguiar PH, Almedida Leme RJ, Mandel M, Andrade AF, Marino R Jr: Epidural hematomas in the posterior cranial fossa. Neurosurg. 2004; 16 (2):
4. Bozbuga M, Izgi N, Polat G, Gurel I: Posterior fossa epidural hematomas: Observation on a series of 73 cases. Neurosurg Rev. 1999; 22: 34-40.
5. Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, Servadei F, Walters BC, Wilberger JE: Surgical management of acute epidural haematomas. Neurosurgery, 2008; 58 (3): S2-7-S2-15.
6. Chowdhury Noman Khaled SM, Raihan MZ, Chowdhury FH, Ashadullah ATM, Sarkar MH, Hossain SS: Surgical management of traumatic extradural haematoma: Experiences with 610 patients and prospective analysis. Indian Journal of Neurotrauma (IJNT), 2008; 5 (2): 75-79.
7. Ciurea AV, Kapsalaki EZ, Coman TC, Roberts JL, Robinson III JS, Tascu A, Brehar F, Fountas KN: Supratentorial epidural hematoma of traumatic etiology in infants. Childs Nerv Syst. 2007; 23: 335–341.
8. Dhellemmes P, Lejeune JP, Christianes JL, Combelles G: Traumatic extradural haematoma in infancy and childhood: Experience with 144 cases. J Neurosurg. 1985; 62: 861-864.
9. Ersahin Y, Mutluer S, Guzelbag E: Extradural Haematoma analysis of 146 cases. Child’s Nerv Syst. 1993; 9: 96-99.
10. Hanci M, Uzan M, Kuday C, Sarioglu A C, Akar Z, Canbaz B, Erdinclear P, Akcura S: Epidural Haematomas in infancy and childhood: Report of 54 cases. Turkis Neurosurgery, 1994; 4: 73-76.
11. Jamjoom A, Cummins B, Jamjoom ZA: Clinical characteristics of traumatic Extradural haematoma: A comparison between children and adults. Neurosurg Rev. 1994; 17: 277-281.
12. Khalid Chowdhary SMN, KM Tarikul Islam, Ehsan Mahmood, Sk Sader THossain. Extra Dural Haematoma in Children: Surgical Experiences and Prospective Analysis of 170 Cases. Turkish Neurosurgery. 2012; Vol. 22, No. 1: 39-43.
13. Leggate JRS, Lopes Ramos N, Genetori I, Lena G, Choux M. Extradural haematoma in infancy, B J Neurosurg. 1989; 3: 533-540.
14. Maggi G, Aliberti F, Petrone G, Roggiero C. Extradural haematoma in children. J Neurosurg Sci. 1998; 42: 95- 99.
15. Mazza C, Pasqualin A, Feriotti G, Da Pian R: Traumatic Extradural Haematoma in children: Experience with
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