The Impact of Time till Surgery on Post-Operative Outcome of Traumatic Extradural Hematoma | [Pakistan Journal of Neurological Surgery • 2024]

Author(s):

1. Waseef Ullah: Department of Neurosurgery, Jinnah International Hospital,Abbottabad, Pakistan

2. Amer Zaman: Department of Neurosurgery, Frontier Medical & Dental College,Abbottabad,Pakistan

3. Junaid Alam: Department of Neurosurgery, Frontier Medical & Dental College,Abbottabad, Pakistan

4. Hameed Ullah: Department of Neurosurgery, Lady Reading Hospital (LRH),Peshawar, Pakistan

5. Irfan Ali: Department of Neurosurgery, Lady Reading Hospital (LRH),Peshawar,Pakistan

6. Faisal Shahzad: Department of Hematology, Frontier Medical & Dental College Abbottabad ,Pakistan

Abstract:

Objective: Traumatic extradural hematoma (EDH) is a common complication of head injuries, predominantly affecting the working-age male population due to increased outdoor activity. This study aimed to assess the impact of timing in surgical intervention and identify factors influencing outcomes. Materials and Methods: Seventy-eight consecutive patients diagnosed with traumatic EDH at Lady Reading Hospital, Peshawar, were included. Patients were categorized into two groups based on the timing of presentation: within 6 hours (early) and after 6 hours (late). Craniotomy and hematoma evacuation were performed, and outcomes were assessed at discharge. Results: In our study mean and SDs for age were 21.83±31.57. Most of the patients i.e., 54(69.2%) were from the 2nd and 3rd decade of life. The mean hematoma volume was 37.17 ml. The majority of the patients were males 65(83.3%) and RTA 32(42.02%) was the most common cause followed by falls and physical assault respectively. The outcome of early operated (within 6 hours) patients was favorable in 44(95.65%) while 2 (4.34%) did not improve (GOS 2,3). Favorable outcomes (GOS 4,5) in delayed presented patients who operated after 6 hours were 23 (71.87%). 5(15.6%) were not improved (GOS 2,3) and 4(12.5%) died (GOS 1). Conclusion: Outcomes of patients who operated early are more favorable than those who were operated late. Delayed presentation and intervention increase the mortality and morbidity of patients having traumatic extradural hematoma.

Page(s): 86-93

DOI: 10.36552/pjns.v28i1.964

Published: Journal: Pakistan Journal of Neurological Surgery, Volume: 28, Issue: 1, Year: 2024

Keywords:

Head trauma , Extradural Hematoma , Glasgow outcome scale , Time to Surgery

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