Epidural hematomas in children

Annals of Emergency Medicine
S A SchutzmanR M Scott

Abstract

To describe the presentation, management, and outcome of children with traumatic epidural hematoma. Retrospective chart review. Fifty-three children diagnosed with traumatic epidural hematoma on computed tomography scan who were treated at Children's Hospital in Boston between 1980 and 1990. Twenty-four of 53 children developed an epidural hematoma after a fall of less than 5 ft. At the time of diagnosis, 51 of 53 children had one or more symptoms of vomiting, headache, or lethargy. Twenty-six patients were alert, 21 were responsive to verbal or painful stimuli, and five were unresponsive or posturing. Twenty-one (40%) had acute neurologic deterioration before surgery; however, 20 (38%) were alert with normal vital signs and neurologic examinations at diagnosis. All patients survived, and at the time of discharge 45 had normal examinations and eight had neurologic abnormalities; at follow-up only four of these eight had persistent (although mild) abnormalities. Although often dramatic in presentation, epidural hematoma may occur after relatively minor head trauma and in alert children with nonfocal neurologic examinations. In our study, incidence of neurologic sequelae increased if abnormal neurologic examination or depressed m...Continue Reading

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Citations

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