The expectant treatment of 'asymptomatic' supratentorial epidural hematomas

T. Y. Chen, C. W. Wong, C. N. Chang, T. N. Lui, W. C. Cheng, M. D. Tsai, T. K. Lin -, M. H. Epstein, N. H. Horwitz

研究成果: 雜誌貢獻文章

68 引文 斯高帕斯(Scopus)


SEVENTY-FOUR PATIENTS WITH a traumatic epidural hematoma (EDH) and a Glasgow Coma Scale score of more than 12 received expectant treatment; 14 subsequently underwent surgical evacuation of the EDH. A patient with initial brain computed tomograms (CT) showing an EDH volume of more than 30 ml, a thickness of more than 15 mm, and a midline shift beyond 5 mm tended to require surgery within 3 days of the injury when the brain had exhausted its compensatory mechanism and yielded to the expanding EDH. After the 3-day period, in the absence of neurological symptoms, the presence of the EDH may not be an indication for surgical evacuation or hospitalization beyond 7 days. In our patients, the presence of a skull fracture in the temporal bone, the heterogeneous density of the EDH in the CT scan, or the 6-hour period between the CT study and the injury did not significantly increase the failure rate of nonsurgical treatment. Although a zero mortality was achieved in this series, these guidelines may not be applicable to the management of an infratentorial EDH.

頁(從 - 到)176-179
出版狀態已發佈 - 1993

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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