Surgical management of acute epidural hematomas.

Academic Article

Abstract

  • INDICATIONS FOR SURGERY: An epidural hematoma (EDH) greater than 30 cm3 should be surgically evacuated regardless of the patient's Glasgow Coma Scale (GCS) score. An EDH less than 30 cm3 and with less than a 15-mm thickness and with less than a 5-mm midline shift (MLS) in patients with a GCS score greater than 8 without focal deficit can be managed nonoperatively with serial computed tomographic (CT) scanning and close neurological observation in a neurosurgical center. TIMING: It is strongly recommended that patients with an acute EDH in coma (GCS score < 9) with anisocoria undergo surgical evacuation as soon as possible. METHODS: There are insufficient data to support one surgical treatment method. However, craniotomy provides a more complete evacuation of the hematoma.
  • Authors

    Published In

  • Neurosurgery  Journal
  • Author List

  • Bullock MR; Chesnut R; Ghajar J; Gordon D; Hartl R; Newell DW; Servadei F; Walters BC; Wilberger JE
  • Volume

  • 58
  • Issue

  • 3 Suppl