Experience of successful conservative management of traumatic large epidural hematoma: a report of 10 cases

doi:10.3877/cma.j.issn.2095-9141.2024.03.007

Abstract

Abstract:

Objective

To investigate the clinical efficacy of successful conservative management of traumatic large epidural hematoma (LTEDH).

Methods

A retrospective analysis was conducted on the clinical data and head CT data of 10 patients with LTEDH who were successfully treated conservatively in Neurosurgery Department of Tianmen First People's Hospital from January 2019 to March 2023. The clinical characteristics and treatment effects were analyzed.

Results

Ten patients with LTEDH were successfully healed by conservative management between 13-44 d with GOS 5 score at discharge. The epidural hematoma began to absorb between 6-13 d after injury and was completely absorbed between 43-90 d after injury by sequential review of the head CT. All patients had no neurological complications when they were followed up for 3-6 months after discharge.

Conclusion

The patients with LTEDH can avoid operate and have good prognosis by conservative management if the patients have the conditions with GCS≥13 score, hematoma thickness within (2.18±0.55) cm and minor neurological impairment.

Key words: Large traumatic epidural hematoma, Conservative management, Traumatic brain injury

Jinpeng Mao, Zhihe Tao, Qi Liu, Yong Wang, Ming Zhou, Jinsong Chen, Shaobin Tian. Experience of successful conservative management of traumatic large epidural hematoma: a report of 10 cases[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2024, 10(03): 164-168.

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References 18

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编号	性别	年龄（岁）	受伤至入院时间	受伤原因	入院GCS评分（分）	神经功能症状	血肿部位	血肿量（mL）	最大血肿厚度（cm）	中线移位（cm）	血肿下水肿
1	男	31	4 h	高处坠落	15	无	右枕顶	35	1.3	0.5	无
2	男	32	2 h	车祸	15	左侧肢体肌力4级	右侧颞顶	59	2.5	0.6	无
3	男	34	6 d	摔伤	15	无	右侧后颅窝	31	2.9	无	有
4	男	35	2 h	树砸伤	15	无	右额	50	2.5	0.4	无
5	男	51	12 h	摔伤	14	无	左顶枕	33	1.2	无	无
6	男	55	1 h	车祸	15	无	左额	31	1.9	无	无
7	男	55	2 h	摔伤	14	无	右颞	48	2.3	0.4	无
8	女	57	1 h	车祸	14	右侧肢体肌力4级	左顶	55	2.5	无	无
9	男	62	1 h	车祸	15	无	左侧颞顶	65	2.3	0.6	无
10	男	75	5 d	摔伤	15	无	双顶	72	2.4	无	无

编号	性别	年龄（岁）	受伤至入院时间	受伤原因	入院GCS评分（分）	神经功能症状	血肿部位	血肿量（mL）	最大血肿厚度（cm）	中线移位（cm）	血肿下水肿
1	男	31	4 h	高处坠落	15	无	右枕顶	35	1.3	0.5	无
2	男	32	2 h	车祸	15	左侧肢体肌力4级	右侧颞顶	59	2.5	0.6	无
3	男	34	6 d	摔伤	15	无	右侧后颅窝	31	2.9	无	有
4	男	35	2 h	树砸伤	15	无	右额	50	2.5	0.4	无
5	男	51	12 h	摔伤	14	无	左顶枕	33	1.2	无	无
6	男	55	1 h	车祸	15	无	左额	31	1.9	无	无
7	男	55	2 h	摔伤	14	无	右颞	48	2.3	0.4	无
8	女	57	1 h	车祸	14	右侧肢体肌力4级	左顶	55	2.5	无	无
9	男	62	1 h	车祸	15	无	左侧颞顶	65	2.3	0.6	无
10	男	75	5 d	摔伤	15	无	双顶	72	2.4	无	无

编号	血肿开始吸收时间	血肿完全吸收时间	症状好转时间（d）	住院时间（d）	甘露醇使用时间（d）	出院/随访GOS评分（分）
1	伤后11 d	不详	11	26	10	5/5
2	伤后9 d	伤后90 d	9	34	10	5/5
3	伤后13 d	不详	11	16	9	5/5
4	伤后11 d	伤后52 d	8	23	8	5/5
5	伤后6 d	伤后43 d	14	27	5	5/5
6	不详	不详	11	21	11	5/5
7	伤后11 d	不详	5	13	5	5/5
8	伤后7 d	伤后57 d	17	44	0	5/5
9	伤后8 d	伤后62 d	7	30	13	5/5
10	不详	不详	10	21	0	5/5

编号	血肿开始吸收时间	血肿完全吸收时间	症状好转时间（d）	住院时间（d）	甘露醇使用时间（d）	出院/随访GOS评分（分）
1	伤后11 d	不详	11	26	10	5/5
2	伤后9 d	伤后90 d	9	34	10	5/5
3	伤后13 d	不详	11	16	9	5/5
4	伤后11 d	伤后52 d	8	23	8	5/5
5	伤后6 d	伤后43 d	14	27	5	5/5
6	不详	不详	11	21	11	5/5
7	伤后11 d	不详	5	13	5	5/5
8	伤后7 d	伤后57 d	17	44	0	5/5
9	伤后8 d	伤后62 d	7	30	13	5/5
10	不详	不详	10	21	0	5/5

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