Extradural hematomas in children. 104 cases.

The authors have studied the clinical features of 104 extradural hematomas in children. The frequency of this complication seems rather high and its severity undeniable. 17 cases were observed in newborns and 2 cases were localized in the posterior fossa. From a clinical point of view, 57% of the children had no disturbances in consciousness at the time of the injury, and 7% had no disturbances at anytime. A lucid interval was found in 68% of the cases, and this was less than 24 h in 60% of the cases. In 19% of the cases there was no skull fracture. Angiography allowed correct diagnosis and a better choice of the surgical technique. The hematoma was distinctly localized in 59 children, whereas it was widespread in 45, meaning that, excepting the coronal suture, the cranial sutures do not limit the spreading of an extradural hematoma. For treatment the authors prefer a bone flap with four or five holes (90 operations). The results are rather unsatisfactory. 18 patients died and in 21 (7.2%) the motor sequelae were the most important complications.