Source of Bleeding and Per-Operative Findings in Extradural Hematoma (EDH): A Three-Year Experience in a Teaching Institute

  • Sohail Amir Doctor
  • Riaz Urrehman
  • Shahid Ayub
  • Muhammad Ali Numan
Keywords: Extradural hematoma, Source of bleeding, Middle meningeal artery


Objective: The objective of this study was to analyze the main source of bleeding and operative findings in an extradural hematoma (EDH).

Material and Methods: A descriptive study was conducted at the Neurosurgery Department of Hayatabad Medical Complex Peshawar from March 2017 to April 2020.The study included 550 patients that met the criteria of inclusion well. Demographic profile, location of Extra-Dural hematoma, the source of bleeding, presence or absence of skull fracture and per operative findings were documented in structured proforma.

Results: 69% were male and 31% were female patients. The middle age group of 21 – 40 years mostly affected. Rupture or laceration of middle meningeal artery was the communal source of bleeding in 355 (64.5%) patients, followed by fracture bone in 285 (51.8%) of patients and dural venous sinus in 70 (12.7%) of patients. Preoperative findings in our study were linear skull fracture in 250 (45.4.0%), underlying contusion in 165 (30%), and contralateral hematoma in 70 (12.7%) of cases.

Conclusion: Rupture or laceration of a Middle meningeal artery (MMA) was the most communal source of bleeding in extradural hematoma. Therefore, per-operative cauterization of this vessel is important to prevent the chances of re-bleed and re-do surgeries.


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