Evaluation of Extradural Haematoma in Rural Population of Central India
Introduction: Traumatic Brain Injury (TBI) is one of the leading health problem in India. Road Traffic Accident (RTA) forms the major bulk for TBI. Extradural Haematoma (EDH) occurs in 1-3% of total TBI patients. Being a rural setup where the study was conducted, data regarding the TBI from cent...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2020-10-01
|
| Series: | International Journal of Anatomy Radiology and Surgery |
| Subjects: | |
| Online Access: | http://www.ijars.net/articles/PDF/2581/45909_CE[Ra1]_F(SHU)_PF1(AB_SHU)_PFA(SHU_AB)_PN(SHU)_PF2(MG_OM).pdf |
| Summary: | Introduction: Traumatic Brain Injury (TBI) is one of the leading
health problem in India. Road Traffic Accident (RTA) forms
the major bulk for TBI. Extradural Haematoma (EDH) occurs
in 1-3% of total TBI patients. Being a rural setup where the
study was conducted, data regarding the TBI from central India
was scanty. It is the need of the hour to get the vital statistics
regarding EDH from central Indian population.
Aim: To evaluate EDH in TBI patients and to find the causes,
clinical presentation, location of EDH and outcome in tertiary
care setup of Central India.
Materials and Methods: This was a retrospective study from
January 2014 to January 2020. Patients admitted with EDH in
Neurosurgery Department were included in the study. Eightyseven patients having EDH were identified and their records
were retrospectively analysed. Various clinical parameters such
as age, sex, duration of presentation to department after injury,
clinical presentation, cause of injury, Glasgow Coma Scale
(GCS) at time of presentation, location of EDH and management
(conservative or surgery) were identified from case records.
Descriptive statistical analysis was performed for above
mentioned parameters in Microsoft excel 2016 along with SPSS
22.0 for applying chi-square test.
Results: Out of 1,325 TBI patients, 87 had EDH. There were 79
males and eight females in the study with male to female ratio
of 9.8:1. The peak age incidence was in third decade of life with
mean age of 34.6 years (SD=22.14 years). Only 12 patients were
presented within 6 hours of incident, while 24 patients presented
within 6-24 hours and remaining 51 presented >24 hours after the
event. RTA was the most common cause for EDH. Most common
clinical presentation was headache followed by altered sensorium
and vomiting. Most of the patients presented with GCS ranging
from 13-15 (n=34, 39.08%) while the percentage of patients with
GCS 3-7 was 33.33% (n=29). The most common location of
haematoma was temporal. Surgical intervention was considered
in 53 patients. Mortality in our study was 14.9%. Amongst the
dead, 62% had seizure history (8 cases). Five out of thirteen
patients died shortly after admission while four patient died while
on conservative management.
Conclusion: To conclude, RTA was the most common and
preventable cause of EDH. Males had more chances of
having EDH with peak age of incidence at third decade of
life. Commonest location of EDH was temporal region. Early
intervention in case of EDH can have good prognosis even
in case of poor GCS. Poor GCS should not be the absolute
contraindication for surgical intervention. |
|---|---|
| ISSN: | 2277-8543 2455-6874 |