INTRODUCTION: Traumatic head/brain injury (TBI) is a leading cause of death and life-long disability in children. The key to successful management of extradural haematoma is early recognition and evacuation. PRESENTATION OF CASE: We report the successful management of a child with life-threatening traumatic brain injury requiring timely surgical intervention outside of a specialist neurosurgical unit. DISCUSSION: Children with an operable injury have improved outcomes if their lesion is surgically evacuated within four hours. This can be challenging in regions located a significant distance from paediatric neurosurgical specialist centres. CONCLUSION: This case supports the recommendation for general surgeons maintaining the skill of burrhole evacuation of extradural haematomas. Whether this will remain feasible in the era of "super-specialisation" is questionable.
INTRODUCTION:Traumatic head/brain injury (TBI) is a leading cause of death and life-long disability in children. The key to successful management of extradural haematoma is early recognition and evacuation. PRESENTATION OF CASE: We report the successful management of a child with life-threatening traumatic brain injury requiring timely surgical intervention outside of a specialist neurosurgical unit. DISCUSSION: Children with an operable injury have improved outcomes if their lesion is surgically evacuated within four hours. This can be challenging in regions located a significant distance from paediatric neurosurgical specialist centres. CONCLUSION: This case supports the recommendation for general surgeons maintaining the skill of burrhole evacuation of extradural haematomas. Whether this will remain feasible in the era of "super-specialisation" is questionable.
Authors: Jerris R Hedges; Craig D Newgard; Judith Veum-Stone; Nathan R Selden; Annette L Adams; Brian S Diggs; Melanie Arthur; Richard J Mullins Journal: J Emerg Med Date: 2008-12-20 Impact factor: 1.484