Incidence, ethology and location of extradural hematoma in surgically managed patients

2021 ◽  
Vol 11 (2) ◽  
pp. 194-196
Author(s):  
Parul Vaid ◽  
Bhavuk Kapoor ◽  
Mayank Kapoor
Keyword(s):  
Ct Scan ◽  
Traffic Accident ◽  
Statistical Evaluation ◽  
Road Traffic ◽  
Age Group ◽  
Health Issues ◽  
Associated Injuries ◽  
Intracranial Injury ◽  
Extradural Hematoma ◽  
Epidemiological Analysis

One of the major public health issues worldwide is traumatic brain injury. EDH is most commonly located in the temporoparietal region. Proper and timely management of these patients improves the outcome. To interpret theincidence, etiology and location of EDH in surgically managed patients.Surgically operated EDH patients were epidemiologically analysed as per the age, gender, mechanism of injury, GCS at admission, site of hematoma and associated intracranial injuries.: Epidemiological analysis of thirty operated EDH patients was done.: Statistical evaluation was done   .EDH was more common (76.67%) among males than females (23.33%). Mostly patients (50%) were in the age group of 21-41 years. Road traffic accident was the most common (50%) mode of trauma leading to EDH occurrence. Temporoparietal EDH was the most common (36.66%) location on CT scan. Most common (70%) associated intracranial injury observed was the skull fractures.: EDH is a serious complication of head injury. Early diagnosis and proper management is required. EDH is more common in men. Careful interpretation of CT scan head is important to get information about the location EDH and other associated injuries before proceeding for surgical evacuation.

scholarly journals Delayed Extradural Hematoma after Evacuation of Contralateral Acute Extradural Hematoma

2020 ◽  
Author(s):  
Majid Anwer ◽  
Atique Ur Rehman ◽  
Farheen Ahmed ◽  
Satyendra Kumar ◽  
Md Masleh Uddin
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Postoperative Period ◽  
Road Traffic ◽  
Case Reports ◽  
Mass Effect ◽  
Extradural Hematoma ◽  
Traumatic Head Injury ◽  
Neurologic Deterioration ◽  
The Right

Abstract Introduction Traumatic head injury with extradural hematoma (EDH) is seen in 2% of patients. Development of EDH on the contralateral side is an uncommon complication that has been reported in various case reports. Case Report We report here a case of an 18-year-old male who had a road traffic injury. He was diagnosed as a case of left-sided large frontotemporoparietal acute extradural bleed with a mass effect toward the right side. He was managed with urgent craniotomy and evacuation of hematoma. A noncontrast computed tomography (NCCT) scan performed 8 hours after postoperative period showed a large frontotemporoparietal bleed on the right side with a mass effect toward the left side. He was again taken to the operating room and right-sided craniotomy and evacuation of hematoma were performed. A postoperative NCCT scan revealed a resolved hematoma. The patient made a complete recovery in the postoperative period and is doing well. Conclusion Delayed onset epidural hematoma is diagnosed when the initial computed tomography (CT) scan is negative or is performed early and when late CT scan performed to assess clinical or ICP deterioration shows an EDH. The diagnosis of such a condition requires a high index of suspicion based on the mechanism of injury along with fracture patterns. Additionally, change in pupillary size, raised intracranial pressure, and bulging of the brain intraoperatively are additional clues for contralateral bleeding. Neurologic deterioration may or may not be associated with delayed EDH presentation. An early postoperative NCCT scan within 24 hours is recommended to detect this complication with or without any neurologic deterioration.

scholarly journals A Delayed and Rather Unusual Presentation of a Bladder Injury after Pelvic Trauma: 5 Years after a Road Traffic Accident

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Nikolaos Davarinos ◽  
John Thornhill ◽  
JP McElwain ◽  
David Moore
Keyword(s):  
Traffic Accident ◽  
Road Traffic ◽  
High Energy ◽  
Pelvic Trauma ◽  
Careful Consideration ◽  
Pelvic Fractures ◽  
Unusual Presentation ◽  
Systematic Evaluation ◽  
Bladder Injury ◽  
Associated Injuries

Associated injuries frequently occur in patients who sustain fractures of the pelvis. Specifically, high-energy trauma resulting in pelvic fractures places the bladder and urethra at risk for injury, often resulting in significant complications. Timely identification and management of genitourinary injuries minimize associated morbidity. Prompt injury identification depends upon a systematic evaluation with careful consideration of the mechanism of injury. Physical examination is pertinent as well as analysis of the urine and appropriate diagnostic imaging. Despite such increased vigilance genitourinary injuries get missed and delayed presentations in the order of a few weeks have been well documented. To our knowledge, this is the first report of its kind in the literature showing such a particularly delayed (5 years) and rather unusual presentation of a bladder injury after pelvic trauma.

scholarly journals A fracture of OS trigonum: a rare case report

2020 ◽  
Vol 7 (1) ◽  
pp. 162
Author(s):  
Gnanaprakash Palaniappan ◽  
Chetan John Rasquinha ◽  
Major K. Kamalanathan
Keyword(s):  
Ct Scan ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Rare Event ◽  
Os Trigonum ◽  
Posterior Process ◽  
Lacerated Wound ◽  
Rare Case Report ◽  
Flap Cover

<p class="abstract">Fractures of os trigonum is an extremely rare event. It is one of the accessory ossicles of the foot found in about 7 % of the population. Very few cases have been reported in the literature about a fracture of the ostrigonum. We present a case of fracture of ostrigonum with associated fracture of the fibula and a large lacerated wound in the leg, in a young man sustained due to road traffic accident. The initial radiological examination with Xray ankle showed a doubtful fracture of posterior process of talus but was not clear. The diagnosis was clinched by CT scan of the ankle with 2mm cuts, which showed clearly a fracture of the os trigonum. It was treated by flap cover for the wound and plaster immobilisation for the fracture. So, any doubtful fracture near the posterior process of talus should be fully assessed radiologically with a CT scan to guide in the treatment.</p>

scholarly journals Outcome of traumatic Extradural Hematoma (EDH) using Glasgow Outcome Scale (GOS)

2018 ◽  
Vol 5 (10) ◽  
pp. 3327
Author(s):  
Dixit V. Prajapati ◽  
Nimish J. Shah
Keyword(s):  
Traffic Accident ◽  
Surgical Intervention ◽  
Road Traffic ◽  
Extradural Hematoma ◽  
Factors Affecting ◽  
Poor Outcome ◽  
Ct Head ◽  
Lost To Follow Up ◽  
Time Of Intervention

Background: Outcome in patient with EDH depends on various factors like GCS at presentation, Volume of hematoma, time of intervention, age, location of hematoma, etc. This study was carried out to find out correlation (if any) between outcome and various factors affecting it. Aim and objectives of this study were to study outcome of patients with traumatic EDH in terms of poor outcome (GOS score 1,2,3), Good outcome (GOS Score 4,5)Methods: This study was carried out in 91 patients having positive CT Head for EDH. Follow up was done every monthly up to 3 months. GOS was recorded at each follow up. Results: Road traffic accident was the most common mode of trauma. 16 patients were operated. Four patients died immediately after diagnosis of traumatic EDH, before doing any intervention. One patient died on 1st post-operative day. After one month, two patients were lost to follow up, 80 patients had GOS 5, four patients had GOS 4. At 2nd and 3rd month, 83 patients had GOS 5, one patient had GOS 4. 17 patients had GCS 3-8, among them, 11 patients had GOS 5, one patient had GOS 4 and five patients died (GOS 1). 15 patients had GCS 9-12, among them, 15 patients had GOS 5. 57 patients had GCS 13-15, among them, 54 patients had GOS 5. 69 patients had EDH volume <30 ml and all patients had GOS 5. 20 patients had EDH volume ≥30 ml, among them, 14 patients had GOS 5, one patient had GOS 4 and five patients died. Conclusions: GOS in EDH patient is affected by GCS and EDH volume at presentation. Lower GCS and larger EDH volume have poor outcome. Surgical intervention in larger EDH volume improves outcome.

scholarly journals Extradural Haematoma in Children: Surgical Experiences and Prospective Analysis of 138 Cases

2014 ◽  
Vol 1 (1) ◽  
pp. 19-24
Author(s):  
Sharif Md. Noman Khaled Chowdhury ◽  
Abdul Hanif ◽  
K M Tarikul Islam ◽  
Ehsan Mahmud ◽  
Sk. Sader Hossain
Keyword(s):  
Traffic Accident ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Road Traffic ◽  
Time Interval ◽  
Extradural Haematoma ◽  
Age Group ◽  
Mortality And Morbidity ◽  
Common Clinical Presentation ◽  
Operative Measures

Objective: The authors present their experiences in the management of xtradural haematoma in children which involved an aggressive diagnostic approach, prompt surgical evacuation of the haematoma results in an excellent outcome.Subjects and methods: 138 consecutive patients with cranial extradural haematoma who underwent surgery in department of Neurosurgery from 1st January 2006 to 31st July 2009 were included in this prospective study. Each of the patients were evaluated in term of age, sex, mode of injury, localization of haematoma, clinical presentation, CT findings, operative measures and outcome.Results: Out of 138 cases 72.47 % were boys and 13.78 % were girls. The boys and girls ratio was 2.64: 1. Age ranges from 1.8 to 15 years with a mean age of 9.49 years. Most of the victims are in first half of second decade of life and closely followed by the 5-10 years age group. The most common mode of injury was fall 40.58 %, (n = 56) followed by Road traffic Accident (RTA) 31.89 %, (n = 44) .The Most common clinical presentation was altered sensorium 59.43 %, (n = 82), followed by Headache / Vomiting 56.53 %, (n = 78).Conclusion: Extradural haematoma in children is a recognized and one of the most rewarding neurosurgical emergencies. It must be recognized and evacuate early to prevent potential mortality and morbidity. Many factors affect the outcome of extradural haematoma surgery. In addition to influence of presence cranial fractures, associated brain lesions and pre-operative neurological condition of patient, duration of time interval between onset of coma and surgical intervention, morbidity and mortality have also been shown to be affected by age – with better prognosis in patients under 10 years of age.DOI: http://dx.doi.org/10.3329/jpsb.v1i1.19450

scholarly journals Study of Traumatic Head Injuries Using Computed Tomography

2021 ◽  
Vol 11 (1) ◽  
pp. 82-86
Author(s):  
Samih Kajoak ◽  
H. Osman ◽  
Caroline Ayad ◽  
Alamin Musa ◽  
Mohammed Yousef ◽  
...  
Keyword(s):  
Ct Scan ◽  
Road Traffic ◽  
Head Injuries ◽  
Age Groups ◽  
Clinical History ◽  
Age Group ◽  
Early Assessment ◽  
Traumatic Head Injury ◽  
Ct Findings ◽  
Traumatic Head

The aim of this retrospective research was to study traumatic head injury (THI) using CT scan and to classify the types of head trauma fractures and types of hemorrhages. Methods and Results: The current study included 53 THI patients (43/81.1%) males and 10/18.9% females) with positive and negative CT scan findings. A complete clinical history and patients’ data were taken from CT reports, which included age, gender, type of trauma, associated injury, and CT findings with their percentages. The study was carried out in Taif city in King Abdelaziz Hospital and King Faisal Hospital. The distribution of various etiologies of THI has shown that the most common etiology was road traffic accident (RTA) (45.3%). The typical age for THI was between 21 to 30 years old (26.4%). The distribution of the traumatic causes for each age group is shown in Table 1. The typical age for RTA was the age group of 11-20 years (33.3%), for falls – the age groups of 0-10 years (33.3%) and over 60 years of age (33.3%). The frequency of various CT findings of THI was as follows: intracranial hemorrhage (56.6%), fracture (39.6%), pneumocephalus (22.6%), contusion (22.6%), foreign body (11.3%), and proptosis (3.8%). The distribution of fracture cases, according to their types, was as follows: a linear fracture (76.2%), comminuted fracture (23.8%), basilar fracture (14.3%), and depressed fracture (9.5%). The frontal bone was the most affected site with fractures (30.7%). Conclusion: CT is an appropriate clinical modality used in the management of THI patients in the emergency department. CT has the advantage of being fast, safe, available, sensitive to most acute post-traumatic injuries, accurate in identifying the head abnormalities such as fractures and hemorrhage during the first 24 hours after injury, which is beneficial in the early assessment, therapy planning, monitoring, and long-term patient care.

scholarly journals Study of cases of head injury in a government hospital in rural Indian setting

2018 ◽  
Vol 5 (10) ◽  
pp. 3252
Author(s):  
Vinod Pusdekar ◽  
Sandeep Ambedkar ◽  
Ritesh Bodade
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Head Injuries ◽  
Age Group ◽  
Road Traffic Accidents ◽  
Government Hospital ◽  
History Of ◽  
Gcs Score

Background: Head injury can be defined as trauma in which the head is struck or moves violently, resulting in transient or permanent alteration of consciousness of an individual. We profiled and analyzed the cases of head injuries reporting to a government hospital a rural Indian setting.Methods: All the patients with history of antecedent head injury were firstly assessed by detailed history, with emphasis on history of unconsciousness/vomiting/convulsions/ENT bleed. Then a thorough clinical examination was undertaken, including Glasgow Coma Scale (GCS) scoring. Further, all the patients were subjected to CT scan of head for correlation of clinical findings, confirmation of diagnosis, delineation of extent of disease and suitability of operative intervention etc.Results: Majority of the patients belonged to 15-44 years age group (30, 60%) and were males (38, 76%). Road traffic accidents accounted for majority (38, 76%) of the cases. GCS score was found to range between 13-15 (mild) in 18 (36%) patients, 9-12 (moderate) in 21 (42%) patients and 3-8 (severe) in 11 (22%) patients. Best recovery (88%) was shown by patients of GCS score between 13-15. Among the critical symptoms and signs, unconsciousness and abnormal plantar reflex were the commonest ones. Generalized cerebral edema without associated lesion (50%) was the commonest finding followed by extradural hematoma (EDH) (40%) on CT scan of head. As for recovery w.r.t. CT scan findings, highest rate of recovery (100%) was reported in patients with fracture without intracranial pathology, while highest mortality was reported in those having mixed lesion (90%).Conclusions: Road traffic accidents in young age group is the commonest mode of head injury and GCS score is a good predictor of recovery in head injury cases.

scholarly journals The Effect of Age on Road Traffic Fatality Index in Ghana

2016 ◽  
Vol 5 (4) ◽  
pp. 111 ◽  
Author(s):  
Christian A. Hesse ◽  
John B. Ofosu ◽  
Samuel K. Darkwah
Keyword(s):  
Analysis Of Variance ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Age Groups ◽  
Age Group ◽  
Road Traffic Accidents ◽  
Older Population ◽  
Traffic Fatality

In this paper, data on road traffic casualties by age groups, from 2009 to 2013, will be used. Using published road traffic casualty statistics from the National Road Safety Commission of Ghana, a 2 ´ 8 contingency table is used to determine whether road traffic casualty and age group are independent. A one factor analysis of variance tests shall be used to conduct a comparative analysis of the rate of road traffic fatalities per 100 casualties across the various age groups in Ghana. A multiple comparison test, using the Fisher least significance difference (LSD) method, shall be conducted to determine which pairs of age groups are significantly different.The study will show that road traffic casualty is not independent of age group. The analysis of variance will show that there are significant differences in road traffic fatality indices (fatality per 100 casualties) among various age groups in Ghana. The risks of dying in a road traffic accident among children under 6 years and older population who are over 65 years are both significantly higher than those of other age groups. This points to the fact that, although smaller number of children under 6 years and older population who are over 65 years die in road traffic accidents each year, more and more people as a proportion of the recorded number of casualties, are being killed through road traffic accidents among these two categories of age groups. Thus, the probability of being killed in a fatal road traffic accident is significantly high in each of these two age groups.

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