A series of post-traumatic midline epidural hematoma and review of the literature

CONCLUSION: Because of the rarity of the lesion and small number of patients, definitive conclusions may be misleading but we think that, in experienced hands, midline epidural hematomas can safely be operated on and, preservation of midline bone strip pro- vides easier bleeding control.

📌 3 Key Takeaways

🎯

Objective & Hypothesis:BACKGROUND: Supratentorial midline epidural hematoma is rare but challenging in diagnosis and management.

📊

Key Findings & Data:METHODS: Nine patients with midline epidural hematoma including two pediatric patients underwent surgery between 2013 and 2018.

💡

Conclusion & Impact:CONCLUSION: Because of the rarity of the lesion and small number of patients, definitive conclusions may be misleading but we think that, in experienced hands, midline epidural hematomas can safely be operated on and, preservation of midline bone strip pro- vides easier bleeding control.

🔬Design:Research Article

📍Scope:2013 Verileri

⚙️Variables:Domain Parameters

Abstract

BACKGROUND: Supratentorial midline epidural hematoma is rare but challenging in diagnosis and management. Indication for surgery can arise even following hospital admission. Being familiar to the presentation and watching out for direct and indirect signs on axial computed tomography (CT) such as suture diastasis or fracture traversing midline are essential to plan multi-planar CT enabling exact diagnosis including form and mass effect of hematoma. METHODS: Nine patients with midline epidural hematoma including two pediatric patients underwent surgery between 2013 and 2018. Pre-operative and post-operative patient status, radiological features, and surgical technique were analyzed. RESULTS: Four patients had deteriorating consciousness levels and two patients had paraparesis. All had fractures traversing midline and epidural hematomas with significant mass effect. They were operated through separated craniotomies around the midline and midline bone strip was used for dural tenting and as support for natural closure of bone flaps. No post-operative complications were developed. All patients were discharged with Glasgow Outcome Score of 5. CONCLUSION: Because of the rarity of the lesion and small number of patients, definitive conclusions may be misleading but we think that, in experienced hands, midline epidural hematomas can safely be operated on and, preservation of midline bone strip pro- vides easier bleeding control.

🔖

Cite This Article

Güçlü, D. G., Öztürk, O., Çırak, M., Can, H., Ünal, T. C., Dolaş, İ., Özgen, U., Aydoseli, A., Sencer, A. (2022). A series of post-traumatic midline epidural hematoma and review of the literature. Ulusal Travma ve Acil Cerrahi Dergisi, Cilt: 28 - Sayı: 6, 805–811. https://ajindex.com/articles/655439

📄 Full Text PDF Viewer

Open in New Tab ↗

↗New Tab

📄

PDF görüntüleyici hazırlanıyor...

References (18)

Wylen EL, Nanda A. Vertex epidural hematoma with coronal suture di- astasis presenting with paraplegia. J Trauma 1998;45:413-415
Guha A, Perrin G, Grossman H, Smyth HS. Vertex epidural hematomas. Neurosurgery 1989;25:824–28
Alexander GL. Extradural haematoma at the vertex. J Neurol Neurosurg Psychiatry 1961;24:381–4
Borzone M, Gentile S, Perria C, Rivano C, Rosa M. Vertex epidural hematomas. Surg Neurol 1979;11:277–84
Jones TL, Crocker M, Martin AJ. A surgical strategy for vertex epidural haematoma. Acta Neurochir (Wien) 2011;153:1819–20
Sahoo RK, Tripathy P. Post traumatic large vertex epidural hematoma without sagittal sinus injury: A case report and review of literature. In- dian J Neurotrauma 2014;11:78–82
Miller DJ, Steinmetz M, McCutcheon IE. Vertex epidural hematoma: surgical versus conservative management: Two case reports and review of literature. Neurosurgery 1999;45:621–5
McKissock W, Taylor JC, Bloom WH, Til K. Extradural hematoma: Ob- servations on 125 cases. Lancet 1960;2:168–72
Lapadula G, Caporlingua F, Paolini S, Missori P, Domenicucci M. Epidu- ral hematoma with detachment of the dural sinuses. J Neurosci Rural Pract 2014;5:191–4
Gorgulu AI, Cobanoglu S, Armagan S, Karabagli H, Tevruz M. Bilateral epidural hematoma. Neurosurg Rev 2000;23:30–3
Columella F, Delzanno GB, NicolaGC. Rare form of epidural hematoma: Epidural hematoma of the vertex. J Neurol Neurosurg Psychiatry 1961;24:381–4
Nemeck AN, Ellenbogen RG, Britz GW. Vertex epidural hematoma. Pe- diatr Neurosurg 2006;41:107–72
Nayil K, Laharwaal M, Dhar A, Wani A, Ramzan A, Arif S. Vertex epidural hematoma with bilateral abducent nerve palsy: Case report and literature review. Turk Neurosurg 2012;22:257–60
Messori A, Paori F, Rychlicki F, Veronesi V, Salvolini U. Acute posttrau- matic paraplegia caused by epidural hematoma at the vertex. AJNR Am J Neuroradiol 2001;22:1748–9
Da Pian R, Benati A, Bricolo A, Tomasi A, Perbellini D, Ore GD. Trau- matic extradural hematoma of the middle third of the superior sagittal sinus. (Italian) Osp Ita Chir 1963;8:667–76
Pomeranz S, Wald U, Zagzag D, Gomori M, Shalit M. Chronic epidural hematoma of the vertex: Problems in detection with computed tomogra- phy. Surg Neurol 1984;22:409–11
Bonilha L, Mattos JP, Borges WA, Fernandes YB, Andrioli MS, Borges G. Chronic epidural hematoma of the vertex. Clin Neurol Neurosurg 2003;106:69–73
Jamieson KG, Yelland JDN. Extradural hemat