Abstract

OUTCOME OF TRAUMATIC SMALL SIZE EPIDURAL HEMATOMA VERSES LARGE SIZE EPIDURAL HEMATOMA: A DESCRIPTIVE STUDY

Saleem Khan*, Ghulam Mustafa, Abid Hussain, Sher Hassan Khan, Nasrullah Lango, Noor Ahamed

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Abstract

Introduction: Traumatic brain injury (TBI) is becoming the most common cause of death and disability worldwide. Currently the incidence of head injury is 50 per 100,000 population in Pakistan and it is rising rapidly with increasing trend in the use of motor vehicles and the use of warfare as the current geopolitical situations. Extradural Haematoma is one of the most serious neurosurgical emergencies following head injury which is surgically treatable and carries a good prognostic outcome after operation. It could be defined as the accumulation of blood in the space between the skull bone and underlying dural membrane. EDH occurs in approximately 1-3% of patients with head injuries and in 5-15% of patients with severe head injuries. Aim of the study is to see the effects of the haematoma size (volume) on the overall outcome of patients as measured by using the functional capabilities of an individual in terms of the (GOS) as the guide. It will help us better understand the effect of haematoma size on the outcome of patients with extradural haematoma. Objective: To determine the Outcome of traumatic small size epidural hematoma verses large size epidural hematoma. Setting: Department of Neurosurgery, Bolan Medial College /BMCH, Quetta. Study design: Descriptive case series. Duration of the study: From March 2022 to February 2023. Material and Methods: This study was conducted at Department of Neurosurgery, Bolan Medial College /BMCH, Quetta in which a total of 188 patients were observed by using 39.3% favourable outcome in large volume haematoma group3, 95% confidence level, 7% margin of error with the help of WHO software. More over non-probability consecutive sampling technique was used for sample collection. Results: In this study 32% patients were in age range 20-30 years, 28% patients were in age range 31-40 years, 22% patients were in age range 41-50 years, 18% patients were in age range 51-60 years. Mean age was 33 years with SD ± 2.71. Seventy five percent patients were male while 25% patients were female. Seventy three percent patients had extradural hematoma 25-50 mL while 27% patients had extradural hematoma >50 mL. Twelve percent patients had GOS score (1-3) while 165(88%) patients had GOS score (4-5). Mean GOS was 3 with SD ± 1.34. Eighty eight percent patients had favourable outcome while 12% patients had unfavourable outcome. Conclusion: There is a strong correlation of outcome in extradural hematoma with its size. The outcome of extradural hematoma was affected by hematoma size. In small hematoma there was a good outcome but in large size hematoma the prognosis was poor.

Keywords: Extradural/epidural haematoma (EDH), GOS, haematoma size (volume), outcome.