Document Detail

The expectant treatment of "asymptomatic" supratentorial epidural hematomas.
MedLine Citation:
PMID:  8437654     Owner:  NLM     Status:  MEDLINE    
Seventy-four patients with a traumatic epidural hematoma (EDH) and a Glasgow Coma Scale score of more than 12 received expectant treatment; 14 subsequently underwent surgical evacuation of the EDH. A patient with initial brain computed tomograms (CT) showing an EDH volume of more than 30 ml, a thickness of more than 15 mm, and a midline shift beyond 5 mm tended to require surgery within 3 days of the injury when the brain had exhausted its compensatory mechanism and yielded to the expanding EDH. After the 3-day period, in the absence of neurological symptoms, the presence of the EDH may not be an indication for surgical evacuation or hospitalization beyond 7 days. In our patients, the presence of a skull fracture in the temporal bone, the heterogeneous density of the EDH in the CT scan, or the 6-hour period between the CT study and the injury did not significantly increase the failure rate of nonsurgical treatment. Although a zero mortality was achieved in this series, these guidelines may not be applicable to the management of an infratentorial EDH.
T Y Chen; C W Wong; C N Chang; T N Lui; W C Cheng; M D Tsai; T K Lin
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  32     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  1993 Feb 
Date Detail:
Created Date:  1993-03-23     Completed Date:  1993-03-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  176-9; discussion 179     Citation Subset:  IM    
Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
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MeSH Terms
Follow-Up Studies
Glasgow Coma Scale
Hematoma, Epidural, Cranial / diagnosis,  surgery*
Skull Fractures / diagnosis,  surgery
Tomography, X-Ray Computed

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