TITLE:
Outcome of Surgically Treated Acute Traumatic Epidural Hematomas Based on the Glasgow Coma Scale
AUTHORS:
Aurélien Ndoumbe, Martine Virginie Patience Ekeme, Chantal Simeu, Samuel Takongmo
KEYWORDS:
Traumatic Brain Injury, Epidural Hematoma, Glasgow Coma Scale, Surgery, Outcome
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.8 No.1,
January
24,
2018
ABSTRACT: This study was a retrospective analysis of outcome of surgically
treated acute traumatic epidural hematomas based on the Glasgow coma scale. The
series enrolled forty-six consecutive cases of acute traumatic epidural
hematomas. The mean
age of patients was 29.56 years and 63.04% of the patients were between 21 and 30 years of age. Forty-tree
out of 46 (93.47%)
of the patients were males. Road traffic crash was the main mode of injury. The severity of the
traumatic brain injury was classified according to the Glasgow coma scale score
at admission. The injury was mild or moderate in 35 (76.08%) cases and severe in 11. Eight patients
(17.39%) presented with pupillary abnormalities. The computed tomography
scanning of the head has objectivized the epidural hematoma in all patients and
has shown a mass effect with midline shift in all but one case (45/46). The
most frequent surgical procedure done was craniotomy. Six (13.04%) patients
died (GOS 1), but 38 (82.60%)
recovered fully (GOS 5) and two (04.34%) were disabled but independent (GOS 4). The Glasgow coma score at
admission was very predictive for good or poor outcome, since all patients but
one who died and all survivors who were disabled were comatose at admission
(GCS ≤ 8).