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. 2010 Jul 1;72(2):124–129. doi: 10.1007/s12262-010-0036-1

Traumatic extradural hematoma — role of non-surgical management and reasons for conversion

Kulwant Singh Bhau 1,2,✉, Shalinder Singh Bhau 2, Sanjay Dhar 2, Shaadi Lal Kachroo 2, M L Babu 2, R K Chrungoo 2
PMCID: PMC3452499  PMID: 23133222

Abstract

Background

To study the role of conservative management and various reasons for conversion to surgical intervention in traumatic extradural hematoma (EDH).

Setting

Government Medical College Jammu.

Materials and methods

One hundred-twenty trauma patients diagnosed as extradural hematoma on CT scan were managed during 1 year period.

Outcomes

Role of conservative management and various reasons for conversion to surgical intervention were studied.

Results

Out of these 120 patients admitted 67 were managed conservatively, 53 cases were operated upon. 31 were operated upon immediately and 22 were operated upon as delayed. There was 1 death and 4 had poor outcome in this group of patients.

Conclusion

It is stressed that small size <10 ml, GCS >12 and locations other than temporal area are the criteria for conservative management. Twenty-two patients out of 89 were needed to be treated surgically during the course of conservative management due to neurodeterioration, increase in size of hematoma on CT, bradycardia, hemiparesis, pupillary abnormalities, delay in referral and only 18% had poor outcome. A strict vigilance is to be kept for clinical deterioration and various reasons mentioned above are to be kept in mind and patients should be subjected to repeated CT scan. Early diagnosis and immediate surgical intervention had good outcome, which shows the fruitful results of early diagnosis and intervention.

Keywords: Extradural hematoma, Head injury, Surgical management, Conservative management

Full Text

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