Evaluation of Conservative Management of Traumatic Extradural Hemorrhage and Role of Surgery during Follow-up

Abstract

Background: The most significant accidental head injury complication is extradural hematoma (EDH), requiring to be diagnosed  immediately and treated either conservative or surgically.

Objective: The current study intended to assess the effectiveness, prognosis, and results of conservative EDH management.

Patients and methods: This prospective study included 30 patients with EDH who were admitted to Zagazig University Hospitals. The  conservative management was performed, only four of the 26 cases that underwent conservative care of EDH during follow-up required surgical intervention.

Results: Patients with Glasgow coma scale score (GCS) 13/15 were 2 cases (6.7%), both cases went for delayed surgical intervention due  to increase size of hematoma to surgical volume and deterioration of conscious level. Patients with GCS 14/15 were 7 cases (23.3%); 2  cases went for delayed surgical intervention due to deterioration and the other 5 cases completed their conservative management.  Patients with GCS 15/15 were 21 cases (70%). All cases who went for surgical intervention at time when they deteriorate, had  improvement for their GCS to be 15/15 with in the first 6 hours postoperatively.

Conclusion: Patients who meet the criteria (volume<30  mm, thickness 9) may benefit from conservative surgical therapy of their EDH. Successful outcomes are produced by the conservative  management, and the advantages of the conservative management of EDH have increased.