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Extra Dural Hematoma an Institutional Experience and Review with a New Insight in its Management

Acharya Suryakanta Pattajoshi , Srikant Das1 , Acharya Suryakanta Pattajoshi2 , Harish Chandra Dhamudia3 , Mahesh Mohanty4 , Paul Joyce5

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International Journal of Neurology and Neurosurgery 12(4):p 171-176, October- December 2020. | DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.12420.14

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Srikant Das, Acharya Suryakanta Pattajoshi, Harish Chandra Dhamudia, et. al. Extra Dural Hematoma, an Institutional Experience and Review with a New Insight in its Management. Int J Neurol Neurosurg. 2020;12(4):171–176.

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Abstract

Background and Aim: Extra Dural hematomas are one of the common neurosurgical emergencies especially affecting young male in their 2nd and 3rd decade. Trauma to the head is the leading cause and occasionally non traumatic etiology like dural arterio venous fistula, sickle cell disease and patients on hemodialysis do develop spontaneous EDH. Usually presents with altered sensorium often preceded by headache with one third of patients shows classical lucid interval. Very often it presents with uncal herniation with anisocoria and rarely with end stage tonsillar herniation. CT scan is gold standard investigation for early diagnosis. Craniotomy and evacuation of hematoma is the most popular and worldwide procedure of choice and it successfully address the problem in majority of cases. Here we evaluated the important prognostic factors and outcome of 85 consecutive patients with extradural hematoma managed surgically. Material and method: Data of 85 consecutive patients of extradural hematoma who were admitted and undergone surgical management in our neurosurgical unit between the period sepember2018 to September 2020 were analyzed. The analysis was mostly made with respect to etiology, and different prognostic factors affecting the surgical outcome. Results: Standard craniotomy was done in 29 patients, trephination was carried out in 44 patients. extended burr hole was performed in 4 patients and 8 patients were subjected to craniectomy. Overall clinical outcome was good with total 5 deaths in the series. Conclusion: Extra Dural hemorrhage is a problem of mainly the younger age group. Trauma is the leading cause and CT accurately detects it. Mostly presents with features of raised ICP and focal neurological deficits .Though it carries a mortality of 10%, patients who undergo early neurosurgical intervention typically have better outcomes than patients who have delayed interventions.

Keywords: Head injury; Extradural hematoma; Glasgow coma scale; Outcome.

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Srikant Das, Acharya Suryakanta Pattajoshi, Harish Chandra Dhamudia, et. al. Extra Dural Hematoma, an Institutional Experience and Review with a New Insight in its Management. Int J Neurol Neurosurg. 2020;12(4):171–176.

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DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.12420.14

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