Retrospective Analysis of Surgical Outcome in Traumatic Extradural Haematoma: An Institutional Experience
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 4
Abstract
Background: Traumatic extradural hematoma (EDH) has been recognized for more than 140 years. 100 years ago, the mortality rate of EDH was as much as 86% and traumatic EDH remains a true neurosurgical emergency. With the introduction and wide availability of cranial CT, early diagnosis and timely surgical intervention for EDH is an attainable gold standard. Indeed, the treatable nature of EDH has led some authors to suggest that ‘‘toward zero mortality’’ is an achievable target with respect to this condition. Aim and Objective: The aim and objective of this research was to study epidemiology, etiology, clinical presentations and the postoperative outcome in patients with head injury with an extradural hematoma. Also to evaluate mortality and functional outcome (GOS) and to formulate recommendations for improvement of therapy. Methods and Materials: This study was done at department of neurosurgery at tertiary care center. Retrospective analysis of collected data through hospital information system of patients operated for traumatic extradural hematoma was done between September 2015 and December 2017. Ethical clearance was obtained from institutional review committee. Categorical data were expressed as rates, ratios and percentages and the comparison was done using chi-square test. Continuous data was expressed as mean ± standard deviation. Results: In our study maximum patients from third decade of life suffered head injury with male predominance. RTA was the commonest cause of traumatic EDH. 80% cases had history of loss of consciousness, “the hallmark symptom of extradural hemorrhage”. 97% of patients presented with equally reacting pupils at the time of admission. Parietal EDH was most common (41.5%) followed by Temporal EDH (39.2%). 72.3% patients were having EDH volume ≤60 ml. Following surgery, 93.9% patients had good recovery, 2.3% patients had moderate disability whereas only 4% patients had severe disability, persistent vegetative state or death until discharge. At 3 months follow up 127 patients (97.7%) had good recovery and 1(0.8%) patient had moderate disability. Conclusion: The present study concludes that, road traffic accident was the commonest mode of causative agent for EDH. Most patients were male and 21-30 years old. Majority of cases had history of loss of consciousness, “the hallmark symptom of extradural hemorrhage” which should be seriously considered while taking history. The degree of brain injury and the GCS difference were notable factors that were significant in determining the functional outcome of EDH. So, early presentation to hospital with mild to moderate GCS has good clinical outcome with minimal disability.
Authors and Affiliations
Brijesh A. Panchal, Shailendra J. Solanki, Ankur Bhupendrakumar Pachani, Jaimin K. Shah, Raj V. Agarbattiwala, Keyur H. Prajapati, Harisinh V. Parmar, Arpit R. Agarwal, Parth D. Lalakia
Keywords
Related Articles
- EP ID EP535226
- DOI 10.21276/ijmrp.2018.4.4.046
- Views 82
- Downloads 0
Comparison of Results of Conservative and Operative (Interlocking Nail) Treatment of Closed Isolated Diaphyseal Tibial Fracture In Female Patients
Background: Closed isolated tibial shaft fractures conventionally have been treated conservatively with closed manipulative reduction and a cast. The aim of this study to compared the radiological outcome after fixation...
Comparative Evaluation of Central Corneal Thickness Among Diabetic And Non-Diabetic Patients Using Pachymeter
Background: The corneal changes in diabetic patients, while perhaps less recognized than retinal complications, are equally important. Diabetes mellitus has a significant effect on morphological, metabolic, physiological...
Immunohistochemical Expression of JAK-P, STAT3 & BCL-2 in Oral Squamous Cell Carcinoma with and Without Lymph Node Metastasis And in Verrucous Carcinoma
Objective: Inappropriate activation of JAK/STAT pathway and BCL-2 occurs with high frequency in human cancers and is associated with cancer cell survival and proliferation. However, its role in oral squamous cell carcino...
Relation of Intrapartum Amniotic Fluid Index to Perinatal Outcome
Objectives: Our objective was to evaluate the usefulness of intrapartum amniotic fluid index (AFI<5) for prediction of fetal distress during labour and subsequent fetal morbidity. Methods: This Descriptive type of observ...
Serum C-Reactive Protein in Enteric Fever in Children: A Hospital Based Study
Background: Enteric fever is endemic in various developing nations. Although the common test for diagnosis is determination of Salmonella typhi cultures. Despite of good specificity and sensitivity, the results of serolo...