Surgical Treatment Outcomes in Patients with „Pure“ Traumatic Epidural Hematoma

Česká verzia

Authors: R. Brabec; V. Beneš lll; P. Buchvald; P. Suchomel
Authors place of work: Neurochirurgické oddělení, Krajská nemocnice Liberec, a. s.
Published in the journal: Cesk Slov Neurol N 2015; 78/111(3): 323-327
Category: Short Communication

Summary

Aim:
The aim of this study was to analyse surgical treatment outcomes in patients with pure epidural hematoma (EDH) treated during 5-year period at the Regional Hospital Liberec.

Patients and methods:
Retrospective analysis of patients with pure EDH treated between 2009 and 2013. We focused on trauma mechanism, alcohol intoxication, ipsilateral skull fracture, hematoma location, initial state of consciousness, time from injury to surgery and the effect of this timing on patient outcome as assessed by Glasgow Outcome Scale (GOS).

Results:
During the study period, 39 patients underwent craniotomy for EDH. Mean age was 38.3 (6–71) years, and 26 patients were men (67%). Most common trauma mechanism was fall (23 cases, 59%), alcohol intoxication was noted in 15 patients (38%). Ipsilateral skull fracture was present in 34 patients (87%). Mean time to diagnosis in patients transferred directly to our hospital was 290 minutes, mean time to surgery 419 minutes. Mean time to diagnosis in patients transferred via a peripheral hospital was 302 minutes, mean time to surgery in these patients was 538 minutes. There was no mortality, 30 patients (77%) achieved GOS 4 or 5, nine patients (23%) GOS 3. Patients’ initial clinical status proved to be significant for favourable GOS. There was no statistically significant difference in GOS between patients transferred directly and those via a peripheral hospital.

Conclusion:
EDH is a serious craniocerebral trauma and its outcome depends on initial clinical status and rapid diagnosis and treatment.

Key words:
epidural hematoma – craniocerebral trauma – prognosis – late diagnosis

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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