Prognostic Factors In Post-Traumatic Cranial Extradural Hematomas

Abstract

This thesis includes 50 patients with traumatic cranial EDI-Is who were admitted and treated in Neurosurgery Department in Menoufiya University Hospital in the period from February 2003 till December 2004. It included 37 males (74%) and 1 3 females (26%) and 72% cf patients between age of 11-40 years. Road traffic accidents (RTA) represented 42% of causes of trauma. Fall from height was the main cause of trauma for those below age of IO years, while RTA was the main cause for those elder than this age. These cases with EDHs presented with headache in 70%, loss of consciousness (LOC) in 94% and lucid interval in 64%, fits in 16% of the total cases. 84% of cases had GCS score above 8 and 16% below 8, motor weakness in 38%, pupillary changes in 16%, and brain stem affection in 8% of the cases. Plain X-ray skull was done for all qases, fissure fractures were found in 76%, depressed fiactures in 14%, and fracture base in 30% of the cases. CT Scan was done for all cases, temporal, parietal hematomas, and those extended to other sites, represented 68% of the cases. Thickness more than 0.5cm was 78%, midline shift more than 0.5cm was 68%, and heterogeneous density was 12% of the cases. 82% were treated surgically, 12% were managed conservatively, and 6% of the cases were managed conservatively at first, then they needed surgical management because of deteriorated neurological states and increased thickness of hematoma. Craniotomy was used in 95.45% and craniectomy ii 4.55% of the surgically managed cases.