Factors Influencing the Outcomes in Extradural Haematoma Patients

Abstract

Background: Extradural hematomas are neurosurgical emergencies and are one of the most common causes of mortality and disability after traumatic brain injury. This study aimed at evaluating the current  management and factors that influence outcome in patients treated for  extradural hematoma in an African setting.

Methods: A total of 224 consecutive patients who were admitted to the neurosurgical unit at the Kenyatta National Hospital and diagnosed with extradural hematoma between January 2007 and December 2011 were included in this study.

Results: There was a male predominance of 96.9%. The median age was 29 years. The most common cause of injury was assault (45%). Good functional recovery was achieved by 190(86.2%) of the patients in our  series, whereas residual disability accounted for 6.7% and mortality for 7.1%. The proportion of patients who achieved functional recovery  significantly decreased with increasing age (p=0.011). A lower GCS score at
admission was associated with a poorer outcome (p=0.032). The time  elapsed from initial trauma to surgery significantly influenced outcome (p=0.007).

Conclusion: A longer duration between trauma and decompression, a low preoperative GCS score, pupillary abnormalities and those older than age 61 are poor prognostic indicators.

Key Words: Extradural hematoma, Head injury, Intracranial hematoma, Outcome