Simultaneous Multiple Extradural Hematomas

Abstract

Objective Simultaneous multiple epidural hematomas (EDHs) are very rare and are associated with high mortality. The purpose of this study is to identify the clinical features, varying mechanisms that may be responsible for production of these hematomas, location of hematomas, and outcome of simultaneous multiple EDHs.

Methods Our study consisted of 528 patients who were admitted in our emergency department with diagnosis of traumatic brain injury (TBI) over a period of 14 months from September 2012 to October 2013 and retrospective analysis of all cases with EDH, particularly those with simultaneous multiple EDHs was done. All the patients were carefully examined clinically, Glasgow Coma Scale (GCS) was noted, plain computed tomographic scan (CT scan) was done and managed accordingly.

Results We came across six cases of multiple EDHs which accounted to 1.13% of all TBI. All of the cases except one were diagnosed within the first 6 hours. The GCS was used for neurological evaluations on admission and during hospital stay. A CT scan was done in all cases. Five patients underwent surgical intervention and one was managed conservatively. Two patients expired due to pre- and postoperative complications.

Conclusion EDHs are serious manifestation of TBI, of which multiple EDHs are even worse. These are life-threatening conditions. Early recognition and treatment can save a precious life. Widespread use of CT scan leads to early diagnosis before deterioration of the neurological status and affects the outcome of surgery.

Keywords

simultaneous multiple extradural hematomas - traumatic brain injury - managed conservatively

Publication History

Received: 17 September 2014

Accepted: 04 December 2014

Publication Date:
30 June 2015 (online)

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