[Dynamics of the course and early prognosis of traumatic intracranial haemorrhages. I. Epidural haematomas (author's transl)].

79 epidural haematomas were surgically treated within a period of 3 years (66 acute and 13 sub-acute courses), half of the cases being due of traffic accidents. The average age was 31.6 years, and the sex distribution male : female = 4 : 1. The most frequent location of the haematoma was temporal (59.5%), followed by parietal (20.3%) as well as frontal and occipital (10.1% each). In only 20.3% of the cases, we found the classical three-stage course with free intervals, whereas primarily persistent and secondarily continuously increasing disturbances of consciousness (34.2% and 45.6% respectively) were more frequent. Dilatation of the pupils on the side of the focus was seen in barely one-half of the patients; in 88.6% of the patients, fracture of the skull was diagnosed on the haematoma side. Diagnosis of haematoma was confirmed either by computed tomography or by angiography of the carotid artery. Early prognosis (mortality = 21.5%) depended on the dynamics of the course of the haematoma (mortality in acute cases 25.8%, in sub-acute courses 0%), the extent of the primary traumatic cerebral damage (manifested by the severity of the disturbance of consciousness) and the rapidity of surgical intervention. The mortality was 45.5% in patients in whom the midbrain had already been affected, as demonstrated by relevant signs with extension spasms and comatose condition of consciousness, whereas the mortality was 75% if both pupils were wide and fixed.