Extradural haematoma - A five-year audit at a tertiary trauma centre in Hong Kong

Abstract

We performed a retrospective analysis of 110 consecutive patients with post-traumatic extradural haematoma (EDH) admitted over a 5-year period (1995-1999). Patients with other associated intracranial lesions, such as cerebral contusion, were included as long as they were not considered to predominate over the EDH. Patients were treated either surgically with craniotomy for haematoma evacuation or conservatively with close observation. Clinical features were reviewed and outcome was assessed at six-month post-injury based on the Glasgow Outcome Score. There were 85 male and 25 female patients, with a mean age of 30 years. Forty-seven patients were managed conservatively and 63 underwent surgery. The overall mortality was 2.7%. Good outcome was found in 100 (90.9%) and poor outcome in 7 (6.4%) of patients. Ninety-one (93.8%) of the 97 patients who were conscious on admission had good outcome. Good outcome was found in (69.2%) of the 13 patients who were unconscious. The three deaths all exhibited signs of severe brain stem compression immediately before surgery and were considered to be unpreventable. With early diagnosis and timely intervention, near-zero mortality is an attainable goal for patients suffering from post-traumatic extradural haematoma.