In patients with acute epidural hematoma treated surgically
Entry
Acute epidural hematomas (AEH)
usually 1.0% after head injury
seen in adults and
The most common etiologic cause in patients
is a traffic accident. Falling in pediatric patients
ranks first among etiological causes
takes.
1,2,3,4 AEH is often temporal
arteria due to fractures in the bone
as a result of injury to the meningea media
emerges. Also more rarely
middle meningeal vein, diploic veins or
as a result of injury to the venous sinuses
can be seen.
1 Source of bleeding
arterial pediatric patients often
It has been reported as venous in patients.
4
presenting with loss of consciousness after trauma
surgery in approximately 9% of cases.
AEH that requires intervention
is reported.
5 AEH is often young
especially in patients aged 20-30 years
seen and is 4 times more common in men.
is monitored.
1,2,3,6,7 Aged and new
very rare at birth
is seen.
4.8
AEH in terms of intracranial location
most frequently considered
in the temporoparietal and temporal regions
seen in 2.0-5.0% of cases.
hematoma can be bilateral.
9,10,12,13,14
AEH is the accumulation of blood in the epidural space.
cause mass effect and this
intracranial pressure depending on the situation
increase findings. Speed and
easy accessibility, multiple trauma
examination of multiple regions in patients
because it allows
Brain tomography (CT) in the diagnosis of AEH
It is a very good test. Also with BT
localization of bleeding, volume, midline shift
presence, accompanying pathologies and skull
detecting fractures in bones
can be achieved. As a result, CT and diagnostic
deciding on surgical treatment
It helps in giving.
cause an increase in intracranial pressure
The main purpose of treatment in AEH with
surgery to remove the effect
evacuation of the hematoma. AEH
treated surgically due to
mortality rate in patients, age and GCS distinction
7.0-12.5% when viewed without
varies between
2,6,9,11 In this study
Diagnosis of acute epidural hematoma in our clinic
placed and surgically treated
factors affecting prognosis in patients
aimed to be investigated.
Method
Mersin University Faculty of Medicine
in the Department of Neurosurgery and Neurosurgery
descriptive type based on records
to our epidemiological study, 2007-2018
89 patients diagnosed with AEH between the years of
has been included. He was diagnosed with AEH in the study,
treated surgically and records
Complete patients were included.
patients who have been treated conservatively
is excluded. Ethics committee of the study
approval, 78017789/050.01.04/1008846
Mersin University Clinic with the number of
Retrieved from the Research Ethics Committee.
Patients age, presentation Glasgow coma scale
(GCS), neurological findings, localization,
hematoma width and operation method.
divided into groups accordingly. obtained in these groups.
mortality, morbidity, intensive care and
taking into account the length of stay in the hospital
prognosis criteria retrospectively.
attempted to be determined.
Normality of continuous measurements
Controls were done with the Shapiro-Wilk test.
Homogeneity of variances tested with Levene's test
was done. Intensive care and hospital stay
GCS groups of data on durations,
type of surgery performed on patients, hematoma
thickness, localization and age groups.
parametric (One Way Anova,
Bonferronni test) and non-parametric
(Mann Whitney U-test and Kruskal Wallis-H
test) were evaluated with tests. motility and
GCS groups of the presence of morbidity, patients
surgical methods, hematoma
The relationship between thickness and age groups was determined by the chi-square test. Craniotomy and
service in patients undergoing craniectomy and
ICU length of stay and morbidity and
presence of mortality parametric and parametric
analyzed with untested tests. Statistics
p<0.05 was taken as significance.
Results
75 (84.2%) of the patients were male, 14 of them
(15.8%) are female and mean age
It was determined as 25.7±14.78. in patients
The most common finding at the time of admission is consciousness.
change was detected (66.9%). Head
The most common cause of trauma was 56 (62.9%)
The patient was identified as a traffic accident.
In 56 (62.9%) of the patients, at least
It was observed that there was one additional pathology.
The most common localization of hematoma
Temporoparietal region in 31 (34.8%) patients
was detected. As a surgical method
With craniotomy in 59 (66.3%) patients
hematoma drainage, in 30 (33.7%) patients
hematoma drainage was performed with craniectomy
. In patients who underwent craniectomy
higher complication rate (33.3%),
mortality (46.6%) and length of hospital stay
(mean 15.3 days) were detected.
Patients who underwent craniectomy
length of stay 15.3 (2-43, craniotomy
It was determined that what was done was 10.6 (3-50) days.
was done (p=0.028). patients in intensive care
When the duration of stay is examined, this value is
10.7 (1-43) in patients who underwent craniectomy
, 5.0 in those who underwent craniotomy
(1-18) days (p= 0.001),