Traumatic extradural hematoma of delayed onset is not a rarity

During a 4.5-year period, 73 patients with traumatic extradural hematoma (EDH) were admitted to the neurosurgical unit of the same hospital and managed with surgical evacuation. Of these consecutive admissions, 22 patients with delayed EDH are reported. The incidence of this condition (30%; 22 of 73) contrasts with reports in the literature of 0 to 10%. This may be related to the availability of computed tomography and its liberal and early use in all head injuries. The overall mortality of traumatic EDH (5%; 4 of 73) was related to cases of delayed onset EDH. In addition to a high index of suspicion, early diagnosis of delayed EDH can be facilitated by liberal use of intracranial pressure monitoring and serial computed tomography.