Pediatric intracranial epidural hematoma outcome

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Pediatric intracranial epidural hematoma outcome

Regardless of the intracranial epidural hematoma size, the clinical status of the patients, the abnormal pupillary findings, or the cause of injury, the outcome and prognosis of the pediatric intracranial epidural hematoma are excellent 1).

Mortality can be significantly reduced with gratifying results if operated early. Best motor response at presentation, pupillary abnormalities, time between injury to surgery, and location of hematoma have been identified as the important factors determining outcome in patients of EDH2) 3) 4) 5).

Binder et al., found that immediate as well as delayed surgical evacuation of EDH resulted in excellent outcomes in most cases. Conservative treatment was started in 76% of our cases – however needing in 35% delayed surgical intervention. Overall in all groups excellent final clinical and neurological outcomes could be reached 6).

Of all laboratory data obtained on admission, the blood potassium, pH and glucose test results correlated significantly with prognosis. Prognosis can be adequately and expeditiously estimated by selected markers within a comprehensive evaluation of children with AEH 7).

References

1)

Gerlach R, Dittrich S, Schneider W, Ackermann H, Seifert V, Kieslich M. Traumatic epidural hematomas in children and adolescents: outcome analysis in 39 consecutive unselected cases. Pediatr Emerg Care. 2009 Mar;25(3):164-9. doi: 10.1097/PEC.0b013e31819a8966. PubMed PMID: 19262419.
2)

Faheem M, Jaiswal M, Ojha BK, Chandra A, Singh SK, Srivastava C. Traumatic Pediatric Extradural Hematoma: An Institutional Study of 228 Patients in Tertiary Care Center. Pediatr Neurosurg. 2019 Jul 9:1-8. doi: 10.1159/000501043. [Epub ahead of print] PubMed PMID: 31288223.
3)

Umerani MS, Abbas A, Aziz F, Shahid R, Ali F, Rizvi RK. Pediatric Extradural Hematoma: Clinical Assessment Using King’s Outcome Scale for Childhood Head Injury. Asian J Neurosurg. 2018 Jul-Sep;13(3):681-684. doi: 10.4103/ajns.AJNS_164_16. PubMed PMID: 30283526; PubMed Central PMCID: PMC6159040.
4)

Erşahin Y, Mutluer S, Güzelbag E. Extradural hematoma: analysis of 146 cases. Childs Nerv Syst. 1993 Apr;9(2):96-9. PubMed PMID: 8319240.
5)

Paşaoğlu A, Orhon C, Koç K, Selçuklu A, Akdemir H, Uzunoğlu H. Traumatic extradural haematomas in pediatric age group. Acta Neurochir (Wien). 1990;106(3-4):136-9. PubMed PMID: 2284988.
6)

Binder H, Majdan M, Tiefenboeck TM, Fochtmann A, Michel M, Hajdu S, Mauritz W, Leitgeb J. Management and outcome of traumatic epidural hematoma in 41 infants and children from a single center. Orthop Traumatol Surg Res. 2016 Oct;102(6):769-74. doi: 10.1016/j.otsr.2016.06.003. Epub 2016 Sep 9. PubMed PMID: 27622712.
7)

Ben Abraham R, Lahat E, Sheinman G, Feldman Z, Barzilai A, Harel R, Barzilay Z, Paret G. Metabolic and clinical markers of prognosis in the era of CT imaging in children with acute epidural hematomas. Pediatr Neurosurg. 2000 Aug;33(2):70-5. PubMed PMID: 11070432.

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