STUDY OBJECTIVE: To describe the presentation, management, and outcome of children with traumatic epidural hematoma. DESIGN: Retrospective chart review. TYPE OF PARTICIPANTS: Fifty-three children diagnosed with traumatic epidural hematoma on computed tomography scan who were treated at Children's Hospital in Boston between 1980 and 1990. MAIN RESULTS: Twenty-four of 53 children developed an epidural hematoma after a fall of less than 5 ft. At the time of diagnosis, 51 of 53 children had one or more symptoms of vomiting, headache, or lethargy. Twenty-six patients were alert, 21 were responsive to verbal or painful stimuli, and five were unresponsive or posturing. Twenty-one (40%) had acute neurologic deterioration before surgery; however, 20 (38%) were alert with normal vital signs and neurologic examinations at diagnosis. All patients survived, and at the time of discharge 45 had normal examinations and eight had neurologic abnormalities; at follow-up only four of these eight had persistent (although mild) abnormalities. CONCLUSIONS: Although often dramatic in presentation, epidural hematoma may occur after relatively minor head trauma and in alert children with nonfocal neurologic examinations. In our study, incidence of neurologic sequelae increased if abnormal neurologic examination or depressed mental status was present at diagnosis. The outcome of children in this study is improved from that of previous studies, perhaps due to increased use of computed tomography and higher incidence of low- or moderate-impact trauma in this series.
STUDY OBJECTIVE: To describe the presentation, management, and outcome of children with traumatic epidural hematoma. DESIGN: Retrospective chart review. TYPE OF PARTICIPANTS: Fifty-three children diagnosed with traumatic epidural hematoma on computed tomography scan who were treated at Children's Hospital in Boston between 1980 and 1990. MAIN RESULTS: Twenty-four of 53 children developed an epidural hematoma after a fall of less than 5 ft. At the time of diagnosis, 51 of 53 children had one or more symptoms of vomiting, headache, or lethargy. Twenty-six patients were alert, 21 were responsive to verbal or painful stimuli, and five were unresponsive or posturing. Twenty-one (40%) had acute neurologic deterioration before surgery; however, 20 (38%) were alert with normal vital signs and neurologic examinations at diagnosis. All patients survived, and at the time of discharge 45 had normal examinations and eight had neurologic abnormalities; at follow-up only four of these eight had persistent (although mild) abnormalities. CONCLUSIONS: Although often dramatic in presentation, epidural hematoma may occur after relatively minor head trauma and in alert children with nonfocal neurologic examinations. In our study, incidence of neurologic sequelae increased if abnormal neurologic examination or depressed mental status was present at diagnosis. The outcome of children in this study is improved from that of previous studies, perhaps due to increased use of computed tomography and higher incidence of low- or moderate-impact trauma in this series.
Authors: Wiebke Gekat; Svenja Binder; Christian Wetzel; Markus A Rothschild; Sibylle Banaschak Journal: Int J Legal Med Date: 2018-07-07 Impact factor: 2.686
Authors: Jonathan N Sellin; Amee Moreno; Sheila L Ryan; Sandi K Lam; Marcella Donaruma-Kwoh; Thomas G Luerssen; Andrew Jea Journal: Childs Nerv Syst Date: 2017-01-03 Impact factor: 1.475
Authors: Zachary Tataryn; Benjamin Botsford; Ron Riesenburger; James Kryzanski; Steven Hwang Journal: Childs Nerv Syst Date: 2013-05-26 Impact factor: 1.475
Authors: Nicky Niele; Frans B Plötz; Ellen Tromp; Bart Boersma; Maarten Biezeveld; Matthijs Douma; Katja Heitink; Gavin Ten Tusscher; Hans B van Goudoever; Marlies A van Houten Journal: Eur J Pediatr Date: 2022-06-24 Impact factor: 3.860