Epidural Hematoma Treated Conservatively: When to Expect the Worst

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
Mohammed BasamhJudith Marcoux

Abstract

The Brain Trauma Foundation's 2006 surgical guidelines have objectively defined the epidural hematoma (EDH) patients who can be treated conservatively. Since then, the literature has not provided adequate clues to identify patients who are at higher risk for EDH progression (EDHP) and conversion to surgical therapy. The goal of our study was to identify those patients. We carried a retrospective review over a 5-year period of all EDH who were initially triaged for conservative management. Demographic data, injury severity and history, neurological status, use of anticoagulants or anti-platelets, radiological parameters, conversion to surgery and its timing, and Glasgow Outcome Scale were analyzed. Bivariate association and further logistic regression were used to point out the significant predictors of EDHP and conversion to surgery. 125 patients (75% of all EDH) were included. The mean age was 39.1 years. The brain injury was mild in 62.4% of our sample and severe in 14.4%. Only 11.2% of the patients required surgery. Statistical comparison showed that younger age (p< 0.0001) and coagulopathy (p=0.009) were the only significant factors for conversion to surgery. There was no difference in outcomes between patients who had EDHP...Continue Reading

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Citations

Apr 15, 2017·Journal of Neurosurgery·Carlos Michel A PeresEberval G Figueiredo
Mar 17, 2018·Journal of Neurosurgery·Raghu SamalaGuru Dutta Satyarthee
Nov 22, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Mohammad Ahmad Jamous
Feb 5, 2021·Medicina·Mariarosaria AromatarioBenedetta Baldari

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