Extradural haematoma in the Irish Republic: an analysis of 82 cases with emphasis on 'delay'

Eighty-two cases of extradural haematoma were analysed to elucidate the factors contributing to delay in treatment and poor outcome. The majority of cases occurred in the first three decades of life with falls being the commonest aetiological factor. Five distinct modes of presentation are described. Excessive delay occurred in recognizing the condition and in subsequent transfer of patients. This resulted in many patients being operated on while in coma. Associated intracranial and extracranial injury occurred in a significant number of cases. Recommendations for the management of these patients are outlined.