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Updated: Jun 23, 2026
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Conservative management of acute epidural hematoma in a pediatric age group
Mohammad A Jamous1, Hani Abdel Aziz, Farouk Al Kaisy
1Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. mojamous@yahoo.com
Insights
Nonoperative management of acute epidural hematoma (EDH) in children with mild head injuries is effective. This approach led to complete resolution of EDH without adverse outcomes in a pediatric case series.
Area of Science:
- Pediatric Neurosurgery
- Traumatic Brain Injury Management
- Neuroradiology
Background:
- Craniotomy and evacuation is the standard surgical treatment for acute epidural hematoma (EDH).
- Increasing use of neuroimaging detects more EDH in mild head injury cases.
Purpose of the Study:
- To evaluate the safety and efficacy of nonoperative management for pediatric acute EDH.
- To assess outcomes in children with mild head injury and EDH treated conservatively.
Main Methods:
- Retrospective chart review of pediatric patients with EDH treated nonoperatively.
- Inclusion criteria: Glasgow Coma Scale score 14-15, confirmed EDH on CT scan.
- Follow-up included neurological exams and serial brain CT scans.
Main Results:
- Six children (3 boys, 3 girls) with acute EDH were successfully managed without surgery.
- All patients achieved a Glasgow Outcome Scale score of 5, indicating no posttraumatic sequelae.
- Follow-up CT scans showed complete resolution of EDH within 2-3 months.
Conclusions:
- Pediatric acute EDH in mild head injury cases can be managed effectively nonoperatively.
- Conservative management is a viable option for selected pediatric patients.
- Recommend nonoperative treatment in specialized pediatric neurosurgical centers with close monitoring.
Objective:
Craniotomy and evacuation is the standard treatment of acute epidural hematoma (EDH). Here, the authors report their experience in nonoperative management of acute EDH in children with mild head injury.
Methods:
The authors retrospectively reviewed charts of patients with conservatively treated EDH at the Department of Neurosurgery, King Abdulla University Hospital, Irbid, Jordan, between August 2003 and October 2007. All patients had a Glasgow Coma Scale score of 14 or 15, and an initial computerized tomography (CT) scan demonstrating an EDH with or without skull fractures. Follow-up included neurological examination and brain CT.
Results:
Six children (3 boys, 3 girls) with acute EDH were successfully managed at our department without surgical intervention. The Glasgow Outcome Scale score of all patients was 5, with no posttraumatic sequelae. Follow-up brain CT showed complete resolution of the EDH within 2-3 months.
Conclusions:
Our results demonstrated that pediatric EDH can be managed nonoperatively. The pronounced increase in the number of CT examinations for patients with head injuries has resulted in a greater proportion of EDH detected in conscious patients. We recommend such treatment be performed in specialized pediatric neurosurgical centers under close neurological observation.
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