Pediatric extradural hematoma : a report of 34 cases

Abstract EN

Background: Extradural hematoma (EDH) resembles a potentially life-threatening condition following head injury in children.

EDHs are less common in children, with few reports had studied the outcome of such patients.

Aim: The current analysis presents the etiology, clinical features and management of 34 patients with traumatic EDHs and identifies the possible factors that could predict the outcome.

Patients and Methods: Patients with traumatic EDH in the age group (0-18) years, admitted to Suez Canal teaching hospital Between January 2013 and March 2016, were analyzed prospectively.

Mode of injury, clinical course, radiological findings and management details were evaluated, and the outcome was measured 3 months after discharge using the pediatric extended Glasgow outcome scale (GOS-E).

Results: The study included 24 boys and 10 girls, with mean age of 9.7 years.

Traffic accident was the commonest mode of injury.

The mean Glasgow Coma Scale (GCS) score at presentation was 12.1±2.3, and headache was the most frequent symptom (61.7%).

Most patients (65%) were managed conservatively, while 35% were operated upon.

Favorable outcome was achieved in 91.1% of patients, and the mortality rate was 5.8%.

Univariate analysis demonstrated an association of the final GOS-E score with the initial Glasgow Coma scale (GCS) score, the mode of injury and the presence of pupillary abnormality or intradural injury.

Conclusions: EDHs can develop following mild head injury in alert children.

Favorable outcome was the rule in most children with traumatic EDHs.

Traffic accident as a mode of injury, low initial GCS score and the presence of pupillary abnormality or intradural injury are statistically significant factors that were linked to a worse outcome.