Traumatic Extradural Haematoma - An Institutional Experience of one year at a tertiary care centre in South India

Dr Bhuvanjee Jha; Dr R Raghavendran

Volume : IX, Issue : VIII, August - 2020

Traumatic Extradural Haematoma - An Institutional Experience of one year at a tertiary care centre in South India

Dr Bhuvanjee Jha, Dr R Raghavendran

Abstract :

Introduction Acute traumatic extradural hematoma (EDH) is a life threatening condition and requires early diagnosis and prompt intervention. It is most frequently caused by traumatic head injury. In this study we analyse the incidence and outcome of consecutive patients with EDH managed at our institute. Materials and Methods: This is a retrospective study of all consecutive patients with acute traumatic EDH admitted and managed in Madras Medical College & Rajiv Gandhi Govt. General Hospital, Chennai, India between Feuary 2019 and January 2020. All patients were analyzed and age, sex, cause of injury, time of presentation, Glasgow Coma Score (GCS), treatment and clinical outcomes were determined. Results: Of 3880 head injuries, 219 (5.64%) had EDH. Males were 188 (85.84%) and females 31 (14.16%). Peak age of incidence was the third decades of life, with a mean age of 33.23 years. Causes were road traffic accidents 156 (71.23%), falls 35 (15.98%) and assault 28 (12.78%) Majority of patients 180 (82.19%) presented within 24 hrs of injury but only few patients 52 (23.74%) presented within 4 h. At presentation 99 patients (45.20%) had GCS of 13–15, 72 patients (32.88%) had 9–12 and 48 (21.92%) had 3–8. The most common location of hematoma was temporo–parietal 131(59.82%). 71(32.42%) patients was operated while 148(67.58%) were managed conservatively. The mortality rate was 12.78% (28 patients) and of these 67.86% had GCS <8. Conclusion: Early diagnosis and appropriate treatment are the cornerstone in the management and it results in the high quality survival (Glasgow Outcome Score 4 or 5) of EDH patients. Low GCS should not be a deterrent in the decision for prompt surgical intervention. All patients should be considered for early seizure prophylaxis with GCS <8.